CT abdomen and pelvis with contrast at Iredell Davis Behavioral Health Hospital. CPT 74177.
What Iredell Davis Behavioral Health Hospital publishes for this service, straight from its standard-charges file, last updated December 31, 2025.
Outpatient / ER
$3,150cash price (self-pay)
$4,500list price
$357–$4,050range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Advantage | $357 |
| BCBS | Blue Medicare Advantage | $357 |
| Cigna | Medicare Advantage | $357 |
| Humana | Medicare Advantage | $357 |
| Longevity | Medicare Advantage | $357 |
| UHC | Medicare Advantage | $357 |
| Wellcare | Medicare Advantage | $364 |
| Devoted | Medicare Advantage | $368 |
| Health Team Alliance | Medicare Advantage | $368 |
| Troy Health | Medicare Advantage | $375 |
| Ambetter | Managed Care | $661 |
| Amerihealth NEXT | Managed Care | $714 |
| Alliance | Managed Medicaid | $1,031 |
| Amerihealth Caritas | Managed Medicaid | $1,031 |
| Carolina Complete Health | Managed Medicaid | $1,031 |
| Healthy Blue | Managed Medicaid | $1,031 |
| Partners | Managed Medicaid | $1,031 |
| Trillium | Managed Medicaid | $1,031 |
| UHC | Managed Care | $1,031 |
| UHC | Managed Medicaid | $1,031 |
| Vaya | Managed Medicaid | $1,031 |
| Wellcare | Managed Medicaid | $1,052 |
| BCBS | All Products | $1,265 |
| Cigna | Managed Care | $1,737 |
| Medcost | Managed Care | $2,700 |
| Multiplan | Managed Care | $4,050 |
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All common services at Iredell Davis Behavioral Health Hospital