CT abdomen and pelvis with contrast at Elizabethtown Community Hospital. CPT 74177.
What Elizabethtown Community Hospital publishes for this service, straight from its standard-charges file, last updated April 28, 2026.
Outpatient / ER
$253cash price (self-pay)
$253list price
$193–$3,515range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Capital District Physicians' Health Plan | Essential Plans | $193 |
| Capital District Physicians' Health Plan | Managed Medicaid | $193 |
| United Healthcare | Managed Medicaid/Essential Plans | $199 |
| Fidelis Care | Child Health Plus | $229 |
| MVP | Essential Plans | $242 |
| MVP | Managed Medicaid | $242 |
| Fidelis Care | Managed Medicaid | $250 |
| Empire BlueCross BlueShield | Essential Plans/Non-Aliessa Managed Medi | $256 |
| Empire BlueCross BlueShield | Managed Medicaid Aliessa | $256 |
| Fidelis Care | Essential Plans | $261 |
| Humana Military | TRICARE | $305 |
| United Healthcare Empire Plan | Commercial PPO for NY State Employees | $342 |
| Aetna | Medicare Advantage | $867 |
| Capital District Physicians' Health Plan | Medicare Advantage | $867 |
| Empire BlueCross BlueShield | Medicare Advantage | $867 |
| Excellus BlueCross BlueShield | Medicare Advantage | $867 |
| Fidelis Care | Medicare Advantage | $867 |
| Martins Point | TRICARE Prime/Department of Defense | $867 |
| MVP | Medicare Advantage | $867 |
| United Healthcare | Medicare Advantage | $867 |
| Veterans Affairs Community Care Network | Veterans Administration | $867 |
| ChoiceCare | Medicare Advantage | $889 |
| Excellus BlueCross BlueShield | Managed Medicaid/Essential Plans | $894 |
| Fidelis Care | Health Benefit Exchange Products | $918 |
| Wellpath | FCI Ray Brook | $1,287 |
| Empire BlueCross BlueShield | Blue Access | $1,305 |
| Empire BlueCross BlueShield | HMO/POS/EPO/PPO/IND | $1,363 |
| Empire BlueCross BlueShield | Individual Network | $1,387 |
| Harvard Pilgrim | Commercial | $1,628 |
| MagnaCare | Commercial | $1,628 |
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