CT abdomen and pelvis with contrast at Jefferson County Hospital. CPT 74177.
What Jefferson County Hospital publishes for this service, straight from its standard-charges file, last updated March 14, 2026.
Outpatient / ER
$1,653cash price (self-pay)
$4,901list price
$1,133–$4,787range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS - OK | Blue Advantage HMO | $1,133 |
| BCBS - OK | Blue Lincs HMO | $1,193 |
| BCBS - OK | Blue Preferred | $1,193 |
| BCBS - OK | Blue Choice PPO | $1,547 |
| BCBS - OK | Blue Traditional PPO | $1,779 |
| Medica | PPO | $2,058 |
| Healthcare Highways | Sync PPO | $2,156 |
| Humana Military Tricare | All Plans | $2,647 |
| Friday Health Plan | PPO | $2,858 |
| Healthcare Highways | Logix PPO | $3,186 |
| United Healthcare | PPO | $3,333 |
| Oklahoma Health Network (OHN) | PPO | $3,921 |
| Aetna | All Plans | $4,166 |
| Coventry | PPO | $4,166 |
| Cigna | PPO/POS | $4,411 |
| First Health | PPO | $4,411 |
| OSMA Health | PPO | $4,411 |
| Preferred Community Choice | PPO | $4,509 |
| HealthSmart | PPO | $4,607 |
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