CT abdomen and pelvis with contrast at OrthoNebraska. CPT 74177.
What OrthoNebraska publishes for this service, straight from its standard-charges file, last updated December 27, 2025.
Outpatient / ER
—cash price (self-pay)
$4,088list price
$80.39–$6,950range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Medicaid | $80.39 |
| Aetna | All Products | $250 |
| BCBS Network Blue | Medicare Advantage | $348 |
| Humana | Medicare Advantage | $348 |
| United Healthcare | Medicare Advantage | $348 |
| United Healthcare | Aarp Medicare Supplement | $348 |
| Paramount Group - Wellcare | Medicare Advantage | $352 |
| Immanuel Pathways | All Products | $355 |
| BCBS Network Blue | Bluecard | $442 |
| Total Care | Medicaid | $442 |
| United Healthcare | Medicaid | $442 |
| United Healthcare | Americhoice | $442 |
| Allied | Insurance IL | $452 |
| Allied | National Global | $452 |
| Ambetter | Commercial-Exchange | $522 |
| Carrum Health | Vflex | $522 |
| Carrum Health | Voluntary Model | $522 |
| Partners Health Alliance | Medicare Advantage | $522 |
| Carrum Health | All Products | $540 |
| Midlands Choice | Medica | $744 |
| Paramount Group - Ambetter | Medicare Advantage | $776 |
| BCBS Of Nebraska Select | All Products | $780 |
| Optum Health | All Products | $2,044 |
| Midlands Choice | Cigna Nfm | $2,289 |
| Midwest Network | All Products | $2,289 |
| BCBS Wellmark Blue | All Products | $2,575 |
| Self Pay | Self Pay | $2,657 |
| Humana | Choicecare | $3,270 |
| Multiplan | Pho | $3,679 |
| United Healthcare | Exchange Plans | $3,884 |
Inpatient
—cash price (self-pay)
$4,088list price
$2,044–$6,950range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Optum Health | All Products | $2,657 |
| BCBS Wellmark Blue | All Products | $2,739 |
| Humana | Choicecare | $3,475 |
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