CT abdomen and pelvis with contrast at Inspira Medical Center Mannington. CPT 74177.
What Inspira Medical Center Mannington publishes for this service, straight from its standard-charges file, last updated March 24, 2026.
Outpatient / ER
$1,654cash price (self-pay)
$1,654list price
$279–$1,216range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare Community Plan | Managed Medicaid | $279 |
| Wellpoint | Managed Medicaid | $279 |
| Fidelis Care of NJ | Managed Medicaid | $335 |
| Aetna Better Health | Managed Medicaid | $335 |
| AmeriHealth Medicare | Medicare Advantage | $399 |
| Clover Health | Medicare Advantage | $399 |
| Braven Health | Medicare Advantage | $399 |
| Horizon NJ Total Care | Medicare Advantage | $399 |
| Aetna Assure Premier Plus | Medicare Advantage | $399 |
| UHC Dual Complete | Medicare Advantage | $399 |
| United Healthcare Medicare | Medicare Advantage | $399 |
| Wellcare Dual Liberty | Medicare Advantage | $399 |
| Wellpoint Full Dual Advantage | Medicare Advantage | $399 |
| Healthspring | Medicare Advantage | $411 |
| Humana | Medicare Advantage | $419 |
| Aetna Medicare | Medicare Advantage | $423 |
| Jefferson Health Plan | Medicare Advantage | $427 |
| Horizon NJ Health | Managed Medicaid | $452 |
| Independence Blue Cross | Commercial | $491 |
| AmeriHealth | Commercial | $491 |
| Cigna | Commercial | $677 |
| Ambetter | Commercial | $817 |
| Oxford Health Plans | Commercial | $1,075 |
| United Healthcare | Commercial | $1,075 |
| Horizon BCBS OMNIA | Commercial | $1,094 |
| Aetna | Commercial | $1,158 |
| Horizon BCBS Managed Care | Commercial | $1,166 |
| Horizon BCBS Indemnity | Commercial | $1,216 |
| Horizon BCBS PPO | Commercial | $1,216 |
| Horizon BCBS SHBP | Commercial | $1,216 |
Inpatient
$1,654cash price (self-pay)
$1,654list price
—range insurers pay
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