CT abdomen and pelvis with contrast at Canton-Potsdam Hospital. CPT 74177.
What Canton-Potsdam Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$2,873cash price (self-pay)
$4,420list price
$109–$216range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cdphp | Medicaid | $109 |
| Fidelis Care New York | Medicaid | $157 |
| Champus-Tricare | Commercial | $185 |
| Aetna | Medicare Advantage | $205 |
| United Healthcare | Medicare Advantage | $205 |
| United Healthcare | Medicare Advantage Dual | $205 |
| Cdphp | Medicare Advantage | $205 |
| Fidelis Care New York | Medicare Advantage | $210 |
| Wellcare | Medicare Advantage Dual | $210 |
| Wellcare | Medicare Advantage | $210 |
| Humana | Medicare Advantage | $216 |
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