CT abdomen and pelvis with contrast at Saratoga Hospital. CPT 74177.
What Saratoga Hospital publishes for this service, straight from its standard-charges file, last updated December 31, 2025.
Outpatient / ER
$157cash price (self-pay)
$313list price
$55.42–$7,646range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CDPHP | Medicaid_NONFAC | $55.42 |
| CDPHP | Medicaid_FAC | $55.42 |
| Blue Cross | EssentialNonAliessa_CSW_NONFAC | $61.13 |
| Blue Cross | EssentialNonAliessa_CSW_FAC | $61.13 |
| Blue Cross | EssentialNonAliessa_Ancillary Providers_FAC | $69.28 |
| Blue Cross | EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_FA | $69.28 |
| Blue Cross | EssentialAliessa-Medicaid-CHP-HARP_Ancillary Providers_NO | $69.28 |
| Blue Cross | EssentialNonAliessa_Ancillary Providers_NONFAC | $69.28 |
| Blue Cross | Blue Access_FAC | $77.70 |
| Blue Cross | Blue Access_NONFAC | $77.70 |
| Blue Cross | Medicare_FAC | $81.50 |
| Blue Cross | Medicare_NONFAC | $81.50 |
| Blue Cross | EssentialAliessa-Medicaid-CHP-HARP_MD_NONFAC | $81.50 |
| Blue Cross | EssentialNonAliessa_MD_NONFAC | $81.50 |
| Blue Cross | EssentialNonAliessa_MD_FAC | $81.50 |
| Blue Cross | EssentialAliessa-Medicaid-CHP-HARP_MD_FAC | $81.50 |
| CDPHP | Medicare_NONFAC | $81.50 |
| CDPHP | Medicare_FAC | $81.50 |
| Emblem Health GHI | Medicare_FAC | $81.50 |
| Blue Cross | HMO_NONFAC | $82.27 |
| Blue Cross | HMO_FAC | $82.27 |
| Aetna | Medicare_FAC | $83.13 |
| Aetna | Medicare_NONFAC | $83.13 |
| Emblem Health GHI | All Products_NONFAC | $89.65 |
| Blue Shield Highmark | Medicare_OFF | $92.39 |
| Blue Shield Highmark | Medicare_NOF | $92.39 |
| Aetna | All Products_NONFAC | $94.03 |
| Aetna | All Products_FAC | $94.03 |
| Blue Cross | PPO_NONFAC | $97.65 |
| Blue Cross | PPO_FAC | $97.65 |
Inpatient
$4,024cash price (self-pay)
$8,048list price
$3,944–$7,646range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Multiplan | PPO | $6,841 |
| United Healthcare | All Products | $7,243 |
| MagnaCare | All Products | $7,646 |
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