CT abdomen and pelvis with contrast at CHI Health St. Francis. CPT 74177.
What CHI Health St. Francis publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$3,559cash price (self-pay)
$6,032list price
$291–$5,670range 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 | $342 |
| Humana | Medicare|All Plans | $342 |
| Medica | Medicare|All Plans | $342 |
| United | Medicare|All Plans | $342 |
| Centene | Medicare|All Plans | $353 |
| Amerigroup | Medicare|All Plans | $360 |
| Great Plains | Medicare|All Plans | $360 |
| Medica | Commercial|ACO | $427 |
| Medica | Commercial|CHI Health | $611 |
| Medica | Commercial|All Other Plans | $640 |
| AMPS | Commercial|All Plans | $760 |
| United | Medicaid|Community Plan | $1,387 |
| Centene | Medicaid|NE Total Care | $1,401 |
| Greater Omaha Packing | Commercial|Narrow Network | $1,536 |
| Millard Public Schools | Commercial|Narrow Network | $1,536 |
| One World | Commercial|Narrow Network | $1,536 |
| Greater Omaha Packing | Commercial|Broad Network | $1,766 |
| Millard Public Schools | Commercial|Broad Network | $1,766 |
| One World | Commercial|Broad Network | $1,766 |
| Timpte | Commercial|Broad Network | $1,766 |
| Creighton University Employees | Commercial|All Plans | $3,318 |
| United | Commercial|All Plans | $3,800 |
| ELAP | Commercial|All Plans | $3,860 |
| Medica | Commercial|Open Access | $5,007 |
| Midlands Choice | Commercial|Premier | $5,007 |
| Midlands Choice | Commercial|Standard | $5,670 |
| MultiPlan PHCS | Commercial|All Plans | $5,670 |
Inpatient
$3,559cash price (self-pay)
$6,032list price
$3,318–$5,670range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Creighton University Employees | Commercial|All Plans | $3,318 |
| United | Commercial|All Plans | $4,826 |
| Medica | Commercial|Open Access | $5,007 |
| Midlands Choice | Commercial|Premier | $5,007 |
| Midlands Choice | Commercial|Standard | $5,670 |
| MultiPlan PHCS | Commercial|All Plans | $5,670 |
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