CT abdomen and pelvis with contrast at Bellevue Hospital Center. CPT 74177.
What Bellevue Hospital Center publishes for this service, straight from its standard-charges file, last updated September 5, 2026.
Outpatient / ER
$356cash price (self-pay)
$2,511list price
$1.00–$2,135range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | MEDICARE ADVANTAGE | $250 |
| MetroPlus | Essential Plan 200-250 | $337 |
| MetroPlus | Essential Plan 1-2 | $337 |
| MetroPlus | Essential Plan 3-4 | $337 |
| Emblem | Hip_ghi_chp | $343 |
| EMBLEM | PPO_Commercial | $343 |
| Fidelis | MAP | $359 |
| Anthem | Medicare Advantage | $423 |
| Emblem | Medicare Advantage | $423 |
| Senior Whole Health | MLTC | $429 |
| Amidacare | Managed Medicaid | $435 |
| Centerlight | PACE | $435 |
| Elderplan | MAP_Medicare Advantage_MLTC | $435 |
| Aetna | ALL PRODUCTS | $447 |
| Anthem HealthPlus | EXCHANGE | $457 |
| Anthem HealthPlus | Managed Medicaid_HARP_MLTC_MAP | $457 |
| Carelon | Managed Medicaid_HARP_CHP | $457 |
| Carelon | GHI BMP | $457 |
| Carelon | Commercial_Essential Plans | $457 |
| Affinity | HARP_Managed Medicaid | $466 |
| Carelon (Amida Care) | Managed Medicaid | $466 |
| Affinity | CHP | $479 |
| Anthem HealthPlus | CHP | $502 |
| EMBLEM | HARP_Managed Medicaid | $571 |
| EMBLEM | Essential Plan 1-2 | $616 |
| ANTHEM | Small Group EPO_PPO | $740 |
| ANTHEM | Blue Access Small Group | $740 |
| ANTHEM | Blue Access Large Group | $764 |
| Anthem | HMO | $825 |
| Anthem | PPO | $825 |
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