CT abdomen and pelvis with contrast at Memorial Hospital. CPT 74177.
What Memorial Hospital publishes for this service, straight from its standard-charges file, last updated July 15, 2026.
Outpatient / ER
$3,855cash price (self-pay)
$3,855list price
$2,159–$3,778range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Ne Total Care Mcaid-All Plans | Ne Total Care Mcaid-All Plans | $2,159 |
| Molina Mcaid-All Plans | Molina Mcaid-All Plans | $2,159 |
| UHC Mcaid | UHC Mcaid | $2,159 |
| Beshp Mcr Adv - All Plans | Beshp Mcr Adv - All Plans | $2,197 |
| Medica Mcare Cost | Medica Mcare Cost | $2,197 |
| Medica Mcr Adv | Medica Mcr Adv | $2,197 |
| Optum Veterans Ccn-All Plans | Optum Veterans Ccn-All Plans | $2,197 |
| UHC Mcr Adv | UHC Mcr Adv | $2,197 |
| BCBS Mcr Adv | BCBS Mcr Adv | $2,197 |
| Tricare - All Plans | Tricare - All Plans | $2,197 |
| Wellcare Mcr Adv - All Plans | Wellcare Mcr Adv - All Plans | $2,241 |
| BCBS Select Bluechoice | BCBS Select Bluechoice | $2,588 |
| BCBS Network Blue - All Other Plans | BCBS Network Blue - All Other Pl | $2,721 |
| UHC Comm-All Other Plans | UHC Comm-All Other Plans | $3,624 |
| UHC Exch | UHC Exch | $3,624 |
| Phcs PPO-All Plans | Phcs PPO-All Plans | $3,662 |
| Medica Elevate | Medica Elevate | $3,701 |
| Ambetter Comm - All Plans | Ambetter Comm - All Plans | $3,701 |
| Medica Comm-All Other Plans | Medica Comm-All Other Plans | $3,701 |
| Midlands Choice-All Plans | Midlands Choice-All Plans | $3,739 |
| Aetna-All Plans | Aetna-All Plans | $3,778 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.