CT abdomen and pelvis with contrast at Novant Health Coastal Carolina Medical Center. CPT 74177.
What Novant Health Coastal Carolina Medical Center publishes for this service, straight from its standard-charges file, last updated March 10, 2026.
Outpatient / ER
$873cash price (self-pay)
—list price
$324–$4,034range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Absolute Total Care | MMP | $324 |
| Absolute Total Care | Medicare Advantage | $324 |
| Aetna | Medicare Advantage | $324 |
| Devoted Health | HMO MA | $324 |
| Devoted Health | PPO MA | $324 |
| Humana | Medicare Advantage | $324 |
| United Healthcare | Medicare Advantage | $324 |
| Molina | MMP | $331 |
| Molina | Medicare Advantage | $331 |
| Cigna | HealthSpring | $334 |
| Clover Insurance Company | HMO MA | $337 |
| Clover Insurance Company | PPO MA | $337 |
| Select Health | MMP | $341 |
| Select Health | Medicare Advantage | $341 |
| Humana | Medicaid | $358 |
| Molina | Medicaid | $358 |
| Select Health | Medicaid | $358 |
| United Healthcare | All Other Plans | $368 |
| United Healthcare | Exchange Plan | $368 |
| United Healthcare | Options PPO | $368 |
| Absolute Total Care | Medicaid | $375 |
| Absolute Total Care | Marketplace | $535 |
| Molina | Marketplace | $535 |
| Select Health | Marketplace | $620 |
| BlueCross BlueShield of South Carolina | State Health Plan | $873 |
| BlueCross BlueShield of South Carolina | Blue Choice Blue Option HIX ( | $2,099 |
| BlueCross BlueShield of South Carolina | Blue Cross Blue Essentials HI | $2,099 |
| BlueCross BlueShield of South Carolina | Blue Choice Health Plan Comme | $4,034 |
| BlueCross BlueShield of South Carolina | Preferred Blue Commercial (PB | $4,034 |
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All common services at Novant Health Coastal Carolina Medical Center