CT abdomen and pelvis with contrast at Lewis County General Hospital. CPT 74177.
What Lewis County General Hospital publishes for this service, straight from its standard-charges file, last updated June 1, 2026.
Outpatient / ER
$2,475cash price (self-pay)
$3,010list price
$527–$3,010range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicaid | $527 |
| EXCELLUS | Medicaid | $527 |
| FIDELIS | Medicaid | $527 |
| MVP | Medicaid | $527 |
| United Healthcare | Medicaid | $527 |
| Mvp | Commercial | $534 |
| Aetna | Medicare | $753 |
| Cdphp | Medicare | $753 |
| Excellus | Medicare | $753 |
| Fidelis | Medicare | $753 |
| Humana | Medicare | $753 |
| Tricare | Commercial | $753 |
| Martins Point | Commercial | $753 |
| Mvp | Medicare | $753 |
| United Healthcare | Medicare | $753 |
| Wellcare | Medicare | $753 |
| Ghi/Emblem Health | Commercial | $978 |
| Aetna | Commercial | $1,317 |
| Excellus | Commercial | $1,880 |
| Empire | Commercial | $1,880 |
| Cdphp | Commercial | $1,957 |
| United HealthCare | COMMERCIAL | $2,258 |
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