CT abdomen and pelvis with contrast at Centrastate Medical Center. CPT 74177.
What Centrastate Medical Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$455cash price (self-pay)
$6,258list price
$185–$5,672range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna Local Plus [5340] | Csmc Cigna Local Plus | $185 |
| Cigna Great West [5305] | Csmc Cigna Oap | $218 |
| Cigna [5012] | Csmc Cigna Oap | $218 |
| Cigna Health Partners [5342] | Csmc Cigna Oap | $218 |
| Allied Benefit Systems [5046] | Csmc Cigna PPO | $240 |
| Centivo [5405] | Csmc Cigna PPO | $240 |
| Cigna Behavioral Health PPO [5323] | Csmc Cigna PPO | $240 |
| Cigna [5012] | Csmc Cigna PPO | $240 |
| Aarp Medicare Comp [5039] | Csmc United Medicare | $395 |
| Aetna Assure Premier Plus [5422] | Csmc Aetna Medicare | $395 |
| Aetna Assure Premier Plus Ip Splits [5466] | Csmc Aetna Medicare | $395 |
| Aetna Centrastate Employee [5425] | Csmc Aetna Ahs Employee | $395 |
| Aetna Mcare Supplemental [5041] | Csmc Aetna Medicare | $395 |
| Aetna Medicare [5003] | Csmc Aetna Medicare | $395 |
| Aetna Medicare [5003] | Csmc Aetna Nnj Prime | $395 |
| Aetna Medicare Ip Splits [5470] | Csmc Aetna Medicare | $395 |
| Ambetter [5432] | Csmc Ambetter Wellcare Of Nj | $395 |
| Amerihealth Administrators Supplemental [5512] | Csmc Amerihealth Medi | $395 |
| Amerihealth Medigap [5049] | Csmc Amerihealth Medicare | $395 |
| Anthem Bcbsny Medicare [5312] | Csmc Horizon Braven | $395 |
| Anthem Bcbsny Medicare Ip Splits [5476] | Csmc Horizon Braven | $395 |
| Anthem Medicare Pffs [5052] | Csmc Horizon Braven | $395 |
| Anthem Medicare Pffs Ip Splits [5474] | Csmc Horizon Braven | $395 |
| Champva [5354] | Csmc Tricare Contract | $395 |
| Amerihealth Caritas Vip Care [5313] | Csmc Amerihealth Caritas | $399 |
| Amerihealth Caritas Vip Care Ip Splits [5460] | Csmc Amerihealth Carit | $399 |
| Aetna [5002] | Csmc Aetna Whole Health | $421 |
| Anthem Bcbsny HMO PPO POS [5310] | Csmc Horizon Commercial | $459 |
| Anthem Bcbsny Indemnity [5311] | Csmc Horizon Commercial | $459 |
| 1199 Seiu Benefit And Pension [5037] | Csmc Aetna | $539 |
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