CT abdomen and pelvis with contrast at Novant Health Clemmons Medical Center. CPT 74177.
What Novant Health Clemmons Medical Center publishes for this service, straight from its standard-charges file, last updated March 30, 2026.
Outpatient / ER
$2,469cash price (self-pay)
$4,115list price
$290–$3,992range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBSFL | Advantage65 | $290 |
| BCBSFL | BlueCare | $290 |
| BCBSFL | BlueMedicare HMO | $290 |
| BCBSFL | BlueMedicare PPO | $290 |
| BCBSFL | BlueSelect | $290 |
| Bcbsfl | HMO | $290 |
| BCBSFL | BlueOptions | $327 |
| BCBSFL | CoverFL | $327 |
| BCBSFL | GoBlue | $327 |
| BCBSFL | NetworkBlue | $327 |
| BCBSFL | BlueChoice | $337 |
| BCBSFL | Essential Network | $337 |
| Bcbsfl | Fep | $337 |
| Bcbsfl | Ppc | $337 |
| Bcbsfl | PPO | $337 |
| BCBSFL | Traditional (PPSPHS) | $337 |
| Blue Cross NC | Blue Medicare | $338 |
| Aetna | Medicare | $347 |
| Cigna | HealthSpring | $349 |
| Carolina Complete | Medicaid | $764 |
| AmeriHealth | Medicaid | $779 |
| Blue Cross NC | Healthy Blue Medicaid | $779 |
| Cigna | ACA | $1,593 |
| Caresource North Carolina | Qualified Health Plan | $1,646 |
| Blue Cross NC | Blue Home | $2,148 |
| Blue Cross NC | Blue Value | $2,222 |
| Atlantic Corporation DBA Atlantic Packaging | All Plans | $2,325 |
| Cigna | Commercial | $2,444 |
| Aetna | Commercial | $2,535 |
| AMPS | All Plans | $2,675 |
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All common services at Novant Health Clemmons Medical Center