CT abdomen and pelvis with contrast at Great Plains Health. CPT 74177.
What Great Plains Health publishes for this service, straight from its standard-charges file.
Outpatient / ER
$193cash price (self-pay)
$2,953list price
$88.00–$5,306range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Ambetter | Commercial | $958 |
| Nebraska Total Care | Medicare Advantage | $1,457 |
| Molina | Medicare Advantage | $1,590 |
| Midwest Network Alliance | Owner | $2,433 |
| Midwest Network Alliance | Non-Owner | $2,519 |
| Blue Cross and Blue Shield of Nebraska | Commercial | $2,558 |
| Medica | Commercial | $2,677 |
| Midlands Choice | Commercial | $2,743 |
| Oscar Health | Midlands Premier | $2,747 |
| United Health Care | Commercial | $2,764 |
| Coventry | HMO | $2,776 |
| GEHA | Commercial | $2,776 |
| Coventry | PPO | $2,806 |
| Mutual of Omaha | Commercial | $2,806 |
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