CT abdomen and pelvis with contrast at Faith Regional Health Services. CPT 74177.
What Faith Regional Health Services publishes for this service, straight from its standard-charges file, last updated September 3, 2026.
Outpatient / ER
$3,962cash price (self-pay)
$6,625list price
$350–$425range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare | Commercial | $350 |
| Aetna | Medicare Advantage | $386 |
| Blue Cross Blue Shield of NE | Medicare Advantage | $386 |
| Ambetter | Medicare Advantage | $398 |
| United Healthcare | Medicare Advantage | $398 |
| Wellcare | Medicare Advantage | $398 |
| Good Samaritan Insurance Plan | Medicare Advantage | $405 |
| Great Plains | Medicare Advantage | $405 |
| Medica | Medicare Advantage | $405 |
| Molina | Medicare Advantage | $425 |
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