CT abdomen and pelvis with contrast at St. John's Riverside Hospital. CPT 74177.
What St. John's Riverside Hospital publishes for this service, straight from its standard-charges file, last updated March 27, 2026.
Outpatient / ER
$2,680cash price (self-pay)
$3,153list price
$368–$3,783range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Fidelis Essential Plans | Fidelis Essential Plans | $368 |
| Fidelis Medicaid | Fidelis Medicaid | $368 |
| Fidelis Health Benefit Exchange | Fidelis Health Benefit Exchange | $412 |
| Aetna | Medicare | $433 |
| Carelon Medicare | Carelon Medicare | $433 |
| Centers Plan For Healthy Living | Centers Plan For Healthy Living | $433 |
| Fidelis | Medicare | $433 |
| HealthFirst | Medicare | $433 |
| HIP Health Plan | Medicare Advantage | $433 |
| MagnaCare | Medicare Advantage | $433 |
| MetroPlus Medicare Advantage | MetroPlus Medicare Advantage | $433 |
| MVP | Medicare | $433 |
| MVP BHS | Medicare | $433 |
| Oscar | Medicare | $433 |
| Partners Health Plan | Dually Enrolled | $433 |
| United Behavioral Health of NY IPA | United Behavioral Health of NY IP | $433 |
| Village Caremax | Village Caremax | $433 |
| Wellcare | Wellcare | $433 |
| MetroPlus Gold | MetroPlus Gold | $455 |
| Oscar | Commercial | $455 |
| United Healthcare | Oxford OX | $589 |
| United Healthcare | Oxford PA | $589 |
| Emblem Health | GHI | $1,187 |
| Emblem Health | HIP | $1,278 |
| MVP Individual Exchange.Student Health Plan | MVP Individual Exchange. | $1,525 |
| Empire Blue Cross Blue Shield PPO | Empire Blue Cross Blue Shield PPO | $1,640 |
| Empire HMO | Empire HMO | $1,640 |
| MVP Commercial | MVP Commercial | $1,798 |
| Cigna | Cigna | $1,967 |
| Aetna Health | Aetna Health | $3,783 |
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