CT abdomen and pelvis with contrast at Great Falls Clinic Hospital. CPT 74177.
What Great Falls Clinic Hospital publishes for this service, straight from its standard-charges file, last updated February 18, 2026.
Outpatient / ER
$250cash price (self-pay)
$3,429list price
$355–$798range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross Blue Shield of MT | Medicare Advantage | $355 |
| Humana | ChoiceCare Medicare Advantage | $355 |
| TriWest | TriWest | $355 |
| MT Automobile Dealers Association Ins | Commercial | $674 |
| Allegiance Benefit Plan | MACo/MMIA | $780 |
| Blue Cross Blue Shield of MT | MT State Employee | $798 |
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