CT abdomen and pelvis with contrast at Children's Nebraska. CPT 74177.
What Children's Nebraska publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
—cash price (self-pay)
$6,433list price
$437–$5,661range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Iowa Medicaid | Managed Medicaid | $437 |
| Wellpoint | Managed Medicaid | $437 |
| Iowa Medicaid | Total Care | $450 |
| Molina (Iowa) | Managed Medicaid | $453 |
| Nebraska Medicaid | Managed Medicaid Community Plan | $617 |
| Nebraska Medicaid | Community Plan - All Products | $617 |
| Nebraska Medicaid | Total Care | $635 |
| Molina (Nebraska) | Managed Medicaid | $660 |
| UHC | TNMC - University Regents | $691 |
| Ambetter | All Products | $713 |
| UHC | All Products | $768 |
| Nebraska Medicaid | Managed Medicaid | $1,994 |
| Midlands Choice CHI | All Products | $4,503 |
| Blue Cross Blue Shield | Select Blue | $4,632 |
| Blue Cross Blue Shield | BluePrint | $5,095 |
| Blue Cross Blue Shield | All Products | $5,146 |
| Midlands Choice Elevate | All Products | $5,146 |
| Avera Health Plan | All Products | $5,468 |
| Centivo | All Products | $5,468 |
| Wellmark | All Products | $5,468 |
| Aetna | All Products | $5,661 |
| Midlands Choice | All Products | $5,661 |
| Sanford Health Plan | All Products | $5,661 |
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