CT abdomen and pelvis with contrast at Ascension St. John Nowata (Jane Phillips Nowata Hospital, Inc.). CPT 74177.
What Ascension St. John Nowata (Jane Phillips Nowata Hospital, Inc.) publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$1,188cash price (self-pay)
$3,210list price
$222–$706range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Whole Health | 2659_mcok, Baok, Ohok Aetna Whole Health 20241001 | $222 |
| Blue Cross Blue Shield Blue Advantage | 2720_nhok Blue Cross Blue Shie | $706 |
| Blue Cross Blue Shield Choice | 2725_nhok Blue Cross Blue Shield Blue | $706 |
| Blue Cross Blue Shield Lincs | 2730_nhok Blue Cross Blue Shield Blue L | $706 |
| Blue Cross Blue Shield Preferred | 2735_nhok Blue Cross Blue Shield Bl | $706 |
| Blue Cross Blue Shield Traditional | 2740_nhok Blue Cross Blue Shield | $706 |
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All common services at Ascension St. John Nowata (Jane Phillips Nowata Hospital, Inc.)