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

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

Outpatient / ER

$2,384cash price (self-pay)

$4,767list price

$291–$4,052range 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	$345
Great Plains \| Medicare\|All Plans	$345
Humana \| Medicare\|All Plans	$345
Medica \| Medicare\|All Plans	$345
United \| Medicare\|All Plans	$345
Centene \| Medicare\|All Plans	$355
Amerigroup \| Medicare\|All Plans	$362
Medica \| Commercial\|ACO	$427
Medica \| Commercial\|CHI Health	$611
Medica \| Commercial\|All Other Plans	$640
AMPS \| Commercial\|All Plans	$765
United \| Medicaid\|Community Plan	$1,096
Centene \| Medicaid\|NE Total Care	$1,107
Greater Omaha Packing \| Commercial\|Narrow Network	$1,189
Millard Public Schools \| Commercial\|Narrow Network	$1,189
One World \| Commercial\|Narrow Network	$1,189
Greater Omaha Packing \| Commercial\|Broad Network	$1,368
Millard Public Schools \| Commercial\|Broad Network	$1,368
One World \| Commercial\|Broad Network	$1,368
Timpte \| Commercial\|Broad Network	$1,368
Creighton University Employees \| Commercial\|All Plans	$1,804
United \| Commercial\|All Plans	$2,143
ELAP \| Commercial\|All Plans	$2,717
Medica \| Commercial\|Open Access	$2,956
Midlands Choice \| Commercial\|Premier	$2,956
Midlands Choice \| Commercial\|Standard	$3,289
MultiPlan PHCS \| Commercial\|All Plans	$4,052

$2,384cash price (self-pay)

$4,767list price

$2,956–$3,814range insurers pay

Insurance plan	Negotiated rate
Medica \| Commercial\|Open Access	$2,956
Midlands Choice \| Commercial\|Premier	$2,956
MultiPlan PHCS \| Commercial\|All Plans	$3,814

Billed more than this?

Snap a photo of your bill. We compare every line with these prices and coding rules, free.