CT abdomen and pelvis with contrast at CHI Health Midlands. CPT 74177.

What CHI Health Midlands publishes for this service, straight from its standard-charges file, last updated February 28, 2026.

Outpatient / ER

$2,051cash price (self-pay)

$4,884list price

$291–$4,151range insurers pay

Insurance plan	Negotiated rate
Amerigroup \| Medicaid\|All Plans	$291
Centene \| Medicaid\|IA Total Care	$291
IAMolina \| Medicaid\|All Plans	$297
BCBS - NE \| Medicare\|All Plans	$348
Humana \| Medicare\|All Plans	$348
Medica \| Medicare\|All Plans	$348
PACE \| Medicare\|All Plans	$348
United \| Medicare\|All Plans	$348
Todays Options \| Medicare\|All Plans	$355
Centene \| Medicare\|All Plans	$358
Amerigroup \| Medicare\|All Plans	$365
Great Plains \| Medicare\|All Plans	$365
Medica \| Commercial\|ACO	$427
Creighton University Employees \| Commercial\|All Plans	$581
Medica \| Commercial\|CHI Health	$611
Medica \| Commercial\|All Other Plans	$640
United \| Commercial\|All Plans	$720
AMPS \| Commercial\|All Plans	$773
Centene \| Medicaid\|NE Total Care	$879
United \| Medicaid\|Community Plan	$879
Greater Omaha Packing \| Commercial\|Narrow Network	$1,005
Millard Public Schools \| Commercial\|Narrow Network	$1,005
One World \| Commercial\|Narrow Network	$1,005
Greater Omaha Packing \| Commercial\|Broad Network	$1,155
Millard Public Schools \| Commercial\|Broad Network	$1,155
One World \| Commercial\|Broad Network	$1,155
Timpte \| Commercial\|Broad Network	$1,155
ELAP \| Commercial\|All Plans	$1,368
Medica \| Commercial\|Open Access	$2,540
Midlands Choice \| Commercial\|Premier	$2,540

$2,051cash price (self-pay)

$4,884list price

$2,930–$4,151range insurers pay

Insurance plan	Negotiated rate
QuikTrip \| Commercial\|All Plans	$2,930
PHCS \| Commercial\|All Plans	$3,468
MultiPlan \| Commercial\|All Plans	$4,151

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