CT abdomen and pelvis with contrast at Boys Town National Research Hospital. CPT 74177.
What Boys Town National Research Hospital publishes for this service, straight from its standard-charges file, last updated December 29, 2025.
Outpatient / ER
$3,811cash price (self-pay)
$4,764list price
$322–$4,621range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Ia Medicaid | $322 |
| Nfm Paramount | Ne Med Employee Plan | $575 |
| Molina Of Nebraska | Managed Medicaid | $617 |
| Nebraska Total Care | Managed Medicaid | $617 |
| UHC | Community Medicaid | $617 |
| UHC | All Products | $700 |
| Medica | Chi Health Network | $731 |
| Medica | All Products | $731 |
| Elap Omaha Firefighters | All Products | $2,620 |
| Aetna | All Products | $3,525 |
| First Health | All Products | $3,525 |
| Methodist | All Products | $3,573 |
| BCBS | All Products | $3,811 |
| Health Partners | All Products | $3,811 |
| Medica | Ifb Network | $3,811 |
| Midlands Choice | All Products | $3,811 |
| Nfm Paramount | Nfm Plan | $3,811 |
| Phcs-Multiplan | All Products | $3,811 |
| BCBS | Wellmark | $4,049 |
| BCBS | Blue Select | $4,621 |
| BCBS | Blueprint | $4,621 |
Inpatient
$3,811cash price (self-pay)
$4,764list price
$2,620–$4,621range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Phcs-Multiplan | All Products | $4,049 |
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