CT abdomen and pelvis with contrast at Pomerene Hospital. CPT 74177.
What Pomerene Hospital publishes for this service, straight from its standard-charges file, last updated March 24, 2026.
Outpatient / ER
$1,986cash price (self-pay)
$2,483list price
$274–$2,309range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicare B OH J15 | Default | $274 |
| AultCare MA | Default | $323 |
| Blue Cross Blue Shield of OH Anthem MCR Adv | Default | $323 |
| Humana Advantage Care Plans Med Advantage | Default | $323 |
| Medical Mutual of Ohio MCR Adv | Default | $323 |
| Medicare A OH J15 | Default | $323 |
| Molina Healthcare of Ohio MCR Adv | Default | $323 |
| SummaCare Health Plan MA | Default | $323 |
| VALOR HEALTH PLAN | Default | $323 |
| Aetna Medicare Advantage | Default | $330 |
| UHC Group Medicare Advantage | Default | $330 |
| Optum Medical Network (Lifeprint) | Default | $330 |
| Blue Cross Blue Shield of OH Anthem | Default | $2,073 |
| AultCare | Default | $2,160 |
| Aetna | Default | $2,185 |
| Medical Mutual of Ohio | Default | $2,185 |
| United Healthcare | Default | $2,185 |
| Cigna | Default | $2,197 |
| SummaCare Health Plan | Default | $2,309 |
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