CT abdomen and pelvis with contrast at Wayne General Hospital. CPT 74177.
What Wayne General Hospital publishes for this service, straight from its standard-charges file, last updated July 31, 2026.
Outpatient / ER
$1,823cash price (self-pay)
$1,823list price
$290–$3,409range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana Military-All Plans | Humana Military-All Plans | $290 |
| Alabama Community Mcaid-All Plans | Alabama Community Mcaid-All Plans | $306 |
| Molina Medicaid | Molina Medicaid | $306 |
| Univita Healthcare Mcaid-All Plans | Univita Healthcare Mcaid-All Plan | $306 |
| Al Healthcare Adv Mcaid-All Plans | Al Healthcare Adv Mcaid-All Plans | $306 |
| Magnolia Medicaid | Magnolia Medicaid | $306 |
| Amerigroup Mcare Adv-All Plans | Amerigroup Mcare Adv-All Plans | $322 |
| Vantage Health Mcare Adv | Vantage Health Mcare Adv | $322 |
| Cigna Mcr Adv | Cigna Mcr Adv | $322 |
| Magnolia Mcare Adv | Magnolia Mcare Adv | $322 |
| Molina Mcare Adv | Molina Mcare Adv | $322 |
| Wellcare Mcare Adv-All Plans | Wellcare Mcare Adv-All Plans | $322 |
| Molina Chip-All Other Plans | Molina Chip-All Other Plans | $336 |
| Ahs-All Plans | Ahs-All Plans | $558 |
| Cigna-All Other Plans | Cigna-All Other Plans | $700 |
| Ml Healthcare-All Plans | Ml Healthcare-All Plans | $729 |
| Vantage Health-All Other Plans | Vantage Health-All Other Plans | $741 |
| Phcs-All Plans | Phcs-All Plans | $1,367 |
| Ms Health Partners-All Plans | Ms Health Partners-All Plans | $1,550 |
| Mhci/Healthlink Op Only-All Plans | Mhci/Healthlink Op Only-All Plans | $1,550 |
| Ppoplus-All Plans | Ppoplus-All Plans | $1,550 |
| First Health-All Plans | First Health-All Plans | $1,641 |
| First Choice-All Other Plans | First Choice-All Other Plans | $1,641 |
| Geha PPO-All Plans | Geha PPO-All Plans | $1,641 |
| Healthcare Advantage-All Plans | Healthcare Advantage-All Plans | $1,641 |
| United Providers-All Plans | United Providers-All Plans | $1,641 |
| Three Rivers Provider Network-All Plans | Three Rivers Provider Networ | $1,732 |
| Aetna Mcare Adv - All Plans | Aetna Mcare Adv - All Plans | $1,823 |
| Magnolia Comm/Exchange-All Other Plans | Magnolia Comm/Exchange-All Ot | $1,823 |
| First Choice Hie | First Choice Hie | $2,279 |
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