CT abdomen and pelvis with contrast at Elkview General Hospital. CPT 74177.
What Elkview General Hospital publishes for this service, straight from its standard-charges file, last updated July 22, 2026.
Outpatient / ER
$2,306cash price (self-pay)
$3,843list price
$178–$3,459range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Better Health OK | Medicaid Replacement | $178 |
| Humana Healthy Horizons MCD Rep | Medicaid Replacement | $178 |
| Medicaid Oklahoma | Default | $178 |
| Medicare B OK JH | Default | $268 |
| Medicare A OK JH | Default | $347 |
| UHC Group Medicare Advantage | Medicare Advantage | $349 |
| United Healthcare | Default | $2,732 |
| Aetna | Default | $3,459 |
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