CT abdomen and pelvis with contrast at Ira Davenport Memorial Hospital. CPT 74177.
What Ira Davenport Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 27, 2026.
Outpatient / ER
$1,367cash price (self-pay)
$6,834list price
$65.35–$6,834range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Empire | All Products Non MD | $230 |
| Empire | All Products MD | $273 |
| Excellus BCBS | Medicare Advantage | $374 |
| FIDELIS | Health Benefit Exchange | $374 |
| Excellus BCBS | All Products | $2,861 |
| Aetna | All Products | $5,809 |
| EMBLEM/GHI | All Products | $6,014 |
| UHC | All Products | $6,834 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.