CT abdomen and pelvis with contrast at Wynn Hospital. CPT 74177.
What Wynn Hospital publishes for this service, straight from its standard-charges file, last updated August 7, 2026.
Outpatient / ER
$3,646cash price (self-pay)
$6,077list price
$65.41–$4,558range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| EXCELLUS HMO MEDICAID APG [350082] | Excellus BCBS Medicaid | $87.21 |
| MEDICAID HMO MISC. [359999] | Misc Medicaid MCO | $87.21 |
| EXCELLUS HMO MEDICAID APG [350082] | Excellus BCBS Medicaid HMO | $87.21 |
| MOLINA HEALTHCARE OF NEW YORK INC LTC [350084] | Misc Medicaid MCO | $87.21 |
| BLUE CROSS NY EXCELLUS MEDICAID [350081] | Excellus BCBS Medicaid | $87.21 |
| BLUE CROSS NY EXCELLUS MEDICAID [350081] | Excellus BCBS Medicaid HMO | $87.21 |
| MVP MEDICAID [350080] | MVP Medicaid | $87.21 |
| CDPHP MEDICAID [350076] | CDPHP Medicaid | $87.21 |
| MEDICAID OUT OF STATE [309999] | Medicaid | $87.21 |
| MEDICAID ALTERNATE [350064] | Medicaid | $87.21 |
| UNITED HEALTHCARE MEDICAID [350013] | UHC Medicaid | $87.21 |
| FIDELIS LTC [350070] | Fidelis HARP | $87.21 |
| UNITED HEALTHCARE MEDICAID [350013] | UHC Essential Plan | $87.21 |
| MEDICAID NY [300033] | Medicaid | $87.21 |
| Wellcare Medicaid [350022] | Hb Mvhs Wellcare Medicaid | $87.21 |
| MEDICAID PENDING [309998] | Medicaid | $87.21 |
| EMBLEM HEALTH MEDICAID [350059] | Misc Medicaid MCO | $87.21 |
| FIDELIS HARP [350063] | Fidelis HARP | $87.21 |
| BLUE CROSS NY EXCELLUS [200041] | Excellus BCBS Medicaid | $87.21 |
| MVP MEDICAID [350080] | MVP Essential Plan | $188 |
| FIDELIS [350058] | Fidelis Essential Plan | $188 |
| FIDELIS ESSENTIAL [350062] | Fidelis Essential Plan | $188 |
| CDPHP MEDICAID [350076] | HB MVHS CDPHP Essential Plans | $196 |
| UNITED HEALTHCARE ALTERNATE [100260] | UHC Empire Plan | $394 |
| CARELON BEHAVIORAL HEALTH [100023] | Carelon Commercial | $435 |
| MEDICARE RAILROAD ALTERNATE [400004] | Medicare | $435 |
| MEDICARE ALTERNATE [400002] | Medicare | $435 |
| Access Compliance [109956] | Hb Mvhs Voucher | $475 |
| FIDELIS EXCHANGE [100254] | Fidelis Health Exchange | $588 |
| CIGNA [100009] | MVP and Cigna Commercial | $1,251 |
Inpatient
$3,646cash price (self-pay)
$6,077list price
$65.41–$4,558range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| EXCELLUS HMO MEDICAID APG [350082] | Excellus BCBS Medicaid | $1,606 |
| BLUE CROSS NY EXCELLUS MEDICAID [350081] | Excellus BCBS Medicaid | $1,606 |
| BLUE CROSS NY EXCELLUS [200041] | Excellus BCBS Medicaid | $1,606 |
| UNITED HEALTHCARE ALTERNATE [100260] | UHC Empire Plan | $2,431 |
| WELLPATH [500030] | WellPath | $3,646 |
| HUMANA [100052] | Humana HMO/POS | $3,950 |
| CIGNA [100009] | MVP and Cigna Commercial | $4,303 |
| MVP [100257] | MVP and Cigna Commercial | $4,303 |
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