CT abdomen and pelvis with contrast at McLaren Northern Michigan. CPT 74177.
What McLaren Northern Michigan publishes for this service, straight from its standard-charges file, last updated December 31, 2025.
Outpatient / ER
$117cash price (self-pay)
$4,288list price
$54.95–$3,216range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| U of M Health Plan | U of M Health Plan | $94.85 |
| McLaren Commercial Ins | McLaren Commercial Ins | $95.04 |
| United Healthcare | United Healthcare | $107 |
| Cofinity Aetna | Cofinity Aetna | $111 |
| Priority Health | Priority Health | $124 |
| Medicaid - United | Medicaid - United | $125 |
| Traditional Medicaid HMO/PPO | Traditional Medicaid HMO/PPO | $125 |
| Medicaid - Molina | Medicaid - Molina | $129 |
| Medicaid - Meridian | Medicaid - Meridian | $195 |
| Medicaid - Midwest | Medicaid - Midwest | $195 |
| Medicaid - Total Healthcare | Medicaid - Total Healthcare | $195 |
| Medicare - Humana | Medicare - Humana | $215 |
| Medicare - Priority Health | Medicare - Priority Health | $215 |
| Traditional Medicare HMO/PPO | Traditional Medicare HMO/PPO | $215 |
| Medicare - Molina | Medicare - Molina | $216 |
| Medicare - United | Medicare - United | $217 |
| Tricare | Tricare | $315 |
| MI Amish Medical Board | MI Amish Medical Board | $348 |
| Medicare - Fidelis | Medicare - Fidelis | $348 |
| Blue Cross Blue Shield | Blue Cross Blue Shield | $522 |
| Medicare - Employee Benefit Logistics | Medicare - Employee Benefit Lo | $557 |
| Cofinity Auto | Cofinity Auto | $662 |
| Workers Compensation | Workers Compensation | $1,492 |
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