CT abdomen and pelvis with contrast at McLeod Health Clarendon. CPT 74177.
What McLeod Health Clarendon publishes for this service, straight from its standard-charges file, last updated July 20, 2026.
Outpatient / ER
$4,836cash price (self-pay)
$6,811list price
$317–$5,449range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Tricare | DHA | $317 |
| Medicare | Medicare | $333 |
| BCBS | Medicare Advantage | $333 |
| Molina Exchange | Medicare Advantage | $333 |
| UHC | Medicare Advantage | $338 |
| Aetna | Medicare Advantage | $342 |
| Clover | Medicare Advantage | $347 |
| Humana | Medicare Advantage | $347 |
| Molina | Medicare Advantage | $355 |
| Molina MMP | Medicare Advantage | $355 |
| Absolute Total Care MMP | Medicare Advantage | $357 |
| Allwell | Medicare Advantage | $357 |
| Wellcare | Medicare Advantage | $357 |
| AMBetter | Medicare Advantage | $600 |
| Medicaid | Medicaid | $662 |
| BCBS Healthy Blue | Medicaid | $662 |
| Asolute Total Care | Medicaid | $681 |
| Molina | Medicaid | $695 |
| Select Health | Medicaid | $695 |
| BCBS | State | $970 |
| BCBS | Hix | $1,335 |
| UHC | Commercial | $2,579 |
| Promise Health | Commerical | $3,342 |
| BCBS | Preferred | $3,493 |
| Cigna | Commercial | $3,696 |
| BCBS | Choice | $3,774 |
| Aetna | Commercial | $5,449 |
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