CT abdomen and pelvis with contrast at Children's Hospital Medical Center_Burnet. CPT 74177.
What Children's Hospital Medical Center_Burnet publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$224cash price (self-pay)
$2,237list price
$57.14–$4,033range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem_IN | Managed_Care_Medicaid_Plan | $144 |
| MHS_IN | Managed_Care_Medicaid_Plan | $145 |
| CareSource_IN | Managed_Care_Medicaid_Plan | $151 |
| CareSource_OH | Managed_Care_Medicaid_Plan | $352 |
| Anthem_OH | Managed_Care_Medicaid_Plan | $367 |
| Humana_OH | Managed_Care_Medicaid_Plan | $367 |
| AmeriHealth_Caritas_OH | Managed_Care_Medicaid_Plan | $377 |
| United_Health_Care_OH | Managed_Care_Medicaid_Plan | $379 |
| Molina_OH | Managed_Care_Medicaid_Plan | $384 |
| Buckeye_OH | Managed_Care_Medicaid_Plan | $402 |
| Aetna_Better_Health_KY | Managed_Care_Medicaid_Plan | $543 |
| Humana_KY | Managed_Care_Medicaid_Plan | $545 |
| Passport_KY | Managed_Care_Medicaid_Plan | $565 |
| Wellcare_KY | Managed_Care_Medicaid_Plan | $571 |
| United_Health_Care_KY | Managed_Care_Medicaid_Plan | $573 |
| Medical_Mutual_of_Ohio_Insurance | All_Exchange_Plans | $1,387 |
| Margaret_Mary_Health_Insurance | All_Commercial_Plans | $1,744 |
| Parkview_Signature_Care_Insurance | EPO_Plan | $1,744 |
| Parkview_Signature_Care_Insurance | PPO_Plan | $1,744 |
| CareSource_OH_Insurance | All_Exchange_Plans | $1,936 |
| United_Health_Care_Insurance | All_Commercial_Plans | $2,004 |
| Aetna_Insurance | All_Commercial_Plans | $2,125 |
| Anthem_Insurance | Non_Traditional_Plans | $2,125 |
| Cigna_Health_Care_Insurance | All_Commericial_Plans | $2,125 |
| Medical_Mutual_of_Ohio_Insurance | All_Commercial_Plans | $2,125 |
| Beechstreet_Insurance | All_Commercial_Plans | $2,192 |
| Anthem_Insurance | Traditional_Plans | $2,198 |
| Point_Comfort_Insurance | All_Commercial_Plans | $2,621 |
| Health_Ohio_Network_Insurance | Elite_Plan | $3,791 |
| Custom_Design_Benefits_Insurance | All_Commercial_Plans | $3,831 |
Inpatient
$224cash price (self-pay)
$2,237list price
$57.14–$4,033range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem_IN | Managed_Care_Medicaid_Plan | $66.67 |
| Aetna_Better_Health_KY | Managed_Care_Medicaid_Plan | $67.76 |
| MHS_IN | Managed_Care_Medicaid_Plan | $68.67 |
| CareSource_IN | Managed_Care_Medicaid_Plan | $70.00 |
| Passport_KY | Managed_Care_Medicaid_Plan | $70.47 |
| Humana_KY | Managed_Care_Medicaid_Plan | $71.14 |
| Wellcare_KY | Managed_Care_Medicaid_Plan | $71.15 |
| United_Health_Care_KY | Managed_Care_Medicaid_Plan | $71.49 |
| Anthem_OH | Managed_Care_Medicaid_Plan | $108 |
| CareSource_OH | Managed_Care_Medicaid_Plan | $108 |
| Humana_OH | Managed_Care_Medicaid_Plan | $108 |
| AmeriHealth_Caritas_OH | Managed_Care_Medicaid_Plan | $111 |
| Molina_OH | Managed_Care_Medicaid_Plan | $113 |
| Buckeye_OH | Managed_Care_Medicaid_Plan | $118 |
| United_Health_Care_OH | Managed_Care_Medicaid_Plan | $128 |
| Cigna_Health_Care_Insurance | All_Commericial_Plans | $1,177 |
| Medical_Mutual_of_Ohio_Insurance | All_Exchange_Plans | $1,387 |
| Margaret_Mary_Health_Insurance | All_Commercial_Plans | $1,744 |
| Parkview_Signature_Care_Insurance | EPO_Plan | $1,744 |
| Parkview_Signature_Care_Insurance | PPO_Plan | $1,744 |
| CareSource_OH_Insurance | All_Exchange_Plans | $1,936 |
| United_Health_Care_Insurance | All_Commercial_Plans | $2,004 |
| Aetna_Insurance | All_Commercial_Plans | $2,125 |
| Anthem_Insurance | Non_Traditional_Plans | $2,125 |
| Medical_Mutual_of_Ohio_Insurance | All_Commercial_Plans | $2,125 |
| Beechstreet_Insurance | All_Commercial_Plans | $2,192 |
| Anthem_Insurance | Traditional_Plans | $2,198 |
| Point_Comfort_Insurance | All_Commercial_Plans | $2,621 |
| Health_Ohio_Network_Insurance | Elite_Plan | $3,670 |
| Custom_Design_Benefits_Insurance | All_Commercial_Plans | $3,831 |
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All common services at Children's Hospital Medical Center_Burnet