CT abdomen and pelvis with contrast at Freeman Hospital West Campus Acute Inpatient Hospital. CPT 74177.
What Freeman Hospital West Campus Acute Inpatient Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$3,285cash price (self-pay)
$8,213list price
$235–$747range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross | Blue Preferred Ppo | $235 |
| Blue Cross | Pathway Essentials Exchange | $235 |
| Blue Cross | Pathway Exchange | $235 |
| Blue Cross | Blue Access Ppo | $299 |
| Aetna | Medicare/Medicaid Managed Care Plan | $349 |
| Allwell | Medicare Managed Care Plan | $353 |
| Devoted Health | Medicare Managed Care Plan | $360 |
| Kansas Health Advantage | Medicare Managed Care Plan | $363 |
| Nhc | Medicare Managed Care Plan | $384 |
| Unitedhealthcare | Exchange | $437 |
| Unitedhealthcare | All Commercial Plans | $490 |
| Unitedhealthcare | Core Other Commercial Plan | $490 |
| Ambetter Health | Other Commercial Plan | $507 |
| Healthchoice | All Commercial Plans | $713 |
| Blue Cross | Traditional | $747 |
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All common services at Freeman Hospital West Campus Acute Inpatient Hospital