CT abdomen and pelvis with contrast at Mount Carmel Dublin Hospital. CPT 74177.
What Mount Carmel Dublin Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$2,080cash price (self-pay)
$3,200list price
$296–$3,200range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medigold Medicare Advantage | Medigold Medicare Advantage | $296 |
| Blue Cross - Oh (Anthem) Medicare Advantage | Anthem BCBS Medicare Adv | $330 |
| United Healthcare Medicare | United Healthcare Medicare Advantage | $336 |
| Medical Mutual Medicare | Medical Mutual Medicare Advantage | $336 |
| The Health Plan | Health Plan Of Ohio Valley Medicare Adv | $343 |
| Aetna Medicare Advantage | Aetna Better Health Medicare Advantage | $346 |
| Molina Medicare Advantage | Molina Medicare Advantage | $346 |
| Caresource Medicare | Caresource Medicare Advantage | $346 |
| Enterprise Group Planning | Enterprise Group Planning Medicare Adv | $649 |
| Custom Design Benefits | Custom Design Benefit | $703 |
| Health Partners | Cigna | $1,126 |
| Mvp | Cigna | $1,126 |
| Healthgram | Cigna | $1,126 |
| Aetna Domestic | Aetna | $1,370 |
| Rural Carrier Health Benefit Plan | Aetna | $1,370 |
| Healthez | Aetna Asa Meritain | $1,437 |
| Group Pension Administrators | Cofinity | $1,494 |
| Group Administrators | Cofinity | $1,494 |
| Access Health | Cofinity | $1,494 |
| Christian Brother Services | Cofinity | $1,494 |
| Sisco Benefits | Cofinity | $1,494 |
| Health Choices | Cofinity | $1,494 |
| Siho Insurance Services | Cofinity | $1,494 |
| Ncas | Cofinity | $1,494 |
| Healthcare Management Admin | Cofinity | $1,494 |
| Key Benefit Administrator | Cofinity | $1,494 |
| Continental Life Insurance | Cofinity | $1,494 |
| Us Health And Life | Cofinity | $1,494 |
| Lucent Health | Cofinity | $1,494 |
| Christian Brothers Holy Cross | Cofinity | $1,494 |
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