CT abdomen and pelvis with contrast at Three Rivers Health. CPT 74177.
What Three Rivers Health publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$3,236cash price (self-pay)
$4,978list price
$201–$4,978range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | MI Medicaid | $201 |
| McLaren | MI Medicaid | $201 |
| Molina | MI Medicaid | $201 |
| Priority Health | MI Medicaid | $201 |
| UHC | MI Medicaid | $201 |
| BCBS of Michigan | Medicare Advantage | $353 |
| Humana | Medicare Advantage | $353 |
| McLaren | Medicare Advantage | $353 |
| Meridian | Medicare Advantage | $353 |
| Priority Health | Medicare Advantage | $353 |
| UHC | Medicare Advantage | $353 |
| Devoted Healthcare | Medicare Advantage | $683 |
| Molina | Medicare Advantage | $923 |
| Plain Church | Commercial | $2,256 |
| UHC | Commercial | $2,364 |
| CHA | Employer Group 4 | $2,987 |
| BCBS of Michigan | Commercial | $3,113 |
| McLaren | Commercial | $3,174 |
| Aetna | Commercial | $3,868 |
| CHA | Commercial | $4,381 |
| Priority Health | Commercial | $4,530 |
| Meridian | Commercial | $4,978 |
Inpatient
$3,236cash price (self-pay)
$4,978list price
$996–$4,978range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Devoted Healthcare | Medicare Advantage | $996 |
| Molina | MI Medicaid | $1,493 |
| Molina | Medicare Advantage | $1,493 |
| BCBS of Michigan | Commercial | $3,084 |
| McLaren | Commercial | $3,174 |
| CHA | Employer Group 4 | $3,734 |
| Aetna | Commercial | $3,868 |
| Plain Church | Commercial | $3,982 |
| Priority Health | Commercial | $3,982 |
| CHA | Commercial | $4,381 |
| Meridian | Commercial | $4,978 |
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