CT abdomen and pelvis with contrast at Holzer Medical Center - Gallipolis. CPT 74177.
What Holzer Medical Center - Gallipolis publishes for this service, straight from its standard-charges file, last updated March 24, 2026.
Outpatient / ER
$2,174cash price (self-pay)
$4,348list price
$330–$4,174range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Ohio Medicare | Traditional | $330 |
| Aetna Medicare | PPO | $330 |
| Aetna Medicare | HMO | $330 |
| Anthem Medicare | HMO | $330 |
| Caresource Exchange | HMO | $462 |
| Anthem Exchange | Pathway X HMO | $2,178 |
| Anthem Exchange | Pathway X PPO | $2,291 |
| Anthem | Blue Access | $2,470 |
| Anthem | Blue Preferred | $2,470 |
| Anthem | Blue Traditional | $2,526 |
| Aetna | PPO | $2,826 |
| Aetna | HMO | $2,826 |
| Aetna | POS | $2,826 |
| Aetna | First Health | $2,826 |
| Cigna | PPO | $2,826 |
| United Healthcare | PPO | $2,826 |
| United Healthcare | POS | $2,826 |
| Medben | Direct Agreement | $2,826 |
| Association Benefit Solutions | Direct Agreement | $3,261 |
| Healthsmart | Accel | $3,261 |
| Ohio Health Choice | PHC-Plus | $3,261 |
| Mmo | PPO | $3,348 |
| Mmo | HMO | $3,348 |
| MMO Marketplace | HMO | $3,348 |
| Quality Care Partners | PPO | $3,391 |
| Quality Care Partners Marketplace | Antidote Health | $3,391 |
| The Health Plan | PPO | $3,478 |
| The Health Plan | POS | $3,478 |
| The Health Plan | HMO | $3,478 |
| The Health Plan | ASO | $3,478 |
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