CT abdomen and pelvis with contrast at Good Samaritan Hospital. CPT 74177.
What Good Samaritan Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$606cash price (self-pay)
$808list price
$340–$1,046range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Managed Care Plan | $340 |
| Medical Mutual of Ohio | Medicare Managed Care Plan | $347 |
| Buckeye | Advantage Medicare Managed Care Plan | $350 |
| BCBS | Anthem KY Pathway Transition HMO Exchange | $425 |
| Buckeye | Ambetter Exchange | $493 |
| Oscar | All Commercial Plans | $510 |
| Aetna | All Commercial Plans | $601 |
| BCBS | Anthem OH I and OH II PPO | $772 |
| Imagine Health | All Commercial Plans | $815 |
| Custom Design Benefits | Exclusive Other Commercial Plan | $836 |
| Custom Design Benefits | TruCost Other Commercial Plan | $874 |
| BCBS | Anthem Blue Connection HMO | $912 |
| MedBen | Tier 1 Other Commercial Plan | $932 |
| MedBen | Tier 2 Other Commercial Plan | $979 |
| BCBS | Anthem Blue Access PPO | $1,046 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.