CT abdomen and pelvis with contrast at Glens Falls Hospital. CPT 74177.
What Glens Falls Hospital publishes for this service, straight from its standard-charges file, last updated December 31, 2025.
Outpatient / ER
$659cash price (self-pay)
$1,318list price
$90.89–$1,120range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Government Program | Medicare Advantage | $211 |
| CDPHP | All Products-Labcorp | $339 |
| CDPHP | All Products-High Deductible Plan | $339 |
| BCBS_Empire HealthChoice | Medicare Advantage | $403 |
| CDPHP | Medicare Advantage | $403 |
| MVP Commercial | Individual_Student Health Plan | $407 |
| MVP Commercial | Small_Large Group_CIGNA | $407 |
| Blue Shield | Medicare Advantage | $420 |
| BCBS_Empire HealthChoice | Managed Medicaid | $441 |
| CDPHP | Managed Medicaid | $441 |
| MVP | Managed Medicaid | $441 |
| Fidelis | Medicaid Managed Care | $485 |
| Blue Shield | PPO | $602 |
| Blue Shield | Indemnity | $602 |
| Blue Shield | HMO_POS | $602 |
| Fidelis | Medicare Advantage | $791 |
| BCBS_Empire HealthChoice | Q-HIP INDEX | $830 |
| BCBS_Empire HealthChoice | Q-HIP CHP | $830 |
| BCBS_Empire HealthChoice | Q-HIP HMO_EPO | $830 |
| BCBS_Empire HealthChoice | Q-HIP PPO | $857 |
| Hamaspik | Medicaid Managed Care | $857 |
| Hamaspik | Medicare Advantage | $857 |
| Nascentia Health Options | Medicare Advantage | $857 |
| Aetna | Commercial | $909 |
| MVP | Essential Plan | $927 |
| MagnaCare | All Products | $989 |
| CDPHP | Essential Plans 1_2_3_4 | $993 |
| Fidelis | Essential Plan | $993 |
| Emblem | Commercial_All Products | $1,054 |
| Empire Plan NYSHIP | All Products | $1,120 |
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