CT abdomen and pelvis with contrast at Wesley Long Hospital. CPT 74177.
What Wesley Long Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$1,570cash price (self-pay)
$4,131list price
$588–$4,048range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Carolina Complete Health | Managed Medicaid | $917 |
| Health Choice | Managed Medicaid | $917 |
| Modivcare | Managed Medicaid | $917 |
| Vaya Health | Managed Medicaid | $931 |
| Vaya Health | Tailored Plan | $931 |
| Vaya Health | Three Way | $931 |
| Partners Health | Managed Medicaid | $935 |
| Partners Health | Tailored Plan | $935 |
| Trillium Health | Managed Medicaid | $935 |
| Trillium Health | Tailored Plan | $935 |
| Humana | Choicecare | $2,623 |
| Beacon Health | Value Options | $3,305 |
| Beach Street | Medicare Advantage | $4,048 |
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