CT abdomen and pelvis with contrast at Grand Lake Health System. CPT 74177.
What Grand Lake Health System publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$3,306cash price (self-pay)
$3,673list price
$346–$564range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana | Medicare Mgd Care | $355 |
| Caresource Advantage | Medicare Mgd Care | $356 |
| Medical Mutual Advantage | Medicare Mgd Care | $360 |
| Aetna | Medicare Mgd Care | $363 |
| Medical Mutual Of Ohio | All Commercial | $415 |
| Caresource Marketplace | All Commercial | $455 |
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