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CT abdomen and pelvis with contrast at HSS Brooklyn Outpatient Center. CPT 74177.

What HSS Brooklyn Outpatient Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.

Outpatient / ER

$615cash price (self-pay)
$615list price
$65.23–$2,289range insurers pay
Insurance planNegotiated rate
UHC | Medicare Managed Care$65.23
Fidelis | Medicaid Managed Care$68.44
Fidelis | Essential Plans 1,2$72.24
Fidelis | Essential Plans 3,4$72.24
Metro Plus | Medicaid Managed Care$91.25
Metro Plus | Essential Plans 3,4$91.25
Emblem | Medicare Managed Care$93.18
Metro Plus | Essential Plans 1,2$95.05
Emblem | City of NY Plans$123
Emblem | Commercial$123
NYSHIP | Commercial$139
UHC | Commercial$144
CIGNA | Commercial$191
Aetna | Commercial$220
Horizon | Commercial$225
Apwu [1016] | Apwu [101600]$771
Cigna [1035] | Local 831 [103508]$771
Luminare - Cigna [1362] | Luminare - Cigna [136200]$771
Cigna [1035] | Cigna [103500]$771
Cigna [1035] | Cigna Indemnity [103505]$771
Cigna [1035] | Cigna HMO [103503]$771
Trustmark - Cigna [1343] | Trustmark - Cigna [134300]$771
Qualcare [1101] | Qualcare [110100]$771
Cigna [1035] | Cigna International [103507]$857
Harvard Pilgrim [1057] | Harvard Pilgrim [105700]$976
Umr [1106] | Umr PPO [110600]$976
Geha [1053] | Geha - Unitedhealthcare [105301]$1,030
Blue Cross Blue Shield Nj [1023] | BCBS Nj PPO [102302]$1,419
Blue Cross Blue Shield NY [1022] | BCBS Blue Access [102216]$1,419
Blue Cross Blue Shield NY [1022] | BCBS Nyship Empire Plan [102209]$1,419
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All common services at HSS Brooklyn Outpatient Center