CT abdomen and pelvis with contrast at Jackson-Madison County General Hospital. CPT 74177.
What Jackson-Madison County General Hospital publishes for this service, straight from its standard-charges file, last updated June 5, 2026.
Outpatient / ER
$201cash price (self-pay)
$670list price
$195–$670range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| River Valley Plan | TennCare | $195 |
| ChoiceCare | Medicare Advantage | $317 |
| Veterans Affairs | Community Care Network | $317 |
| Cigna-HealthSpring | Medicare Advantage | $319 |
| Blue Cross Blue Shield of Tennessee | BlueCare | $326 |
| Blue Cross Blue Shield of Tennessee | BlueChoice HMO | $326 |
| Aetna | Whole Health | $328 |
| Aetna | West TN Employee Network | $361 |
| United Healthcare | All Payer | $363 |
| Aetna | Commercial | $384 |
| Blue Cross Blue Shield of Tennessee | Network S/E | $458 |
| Celtic Insurance Company | Commercial-Exchange | $491 |
| Blue Cross Blue Shield of Tennessee | Network P | $497 |
| ChoiceCare | Commercial | $503 |
| Oscar | HMO/Medicare Advantage/PPO/EPO/POS | $650 |
| ChoiceCare | KY Medicaid HMO | $670 |
Inpatient
$201cash price (self-pay)
$670list price
$430–$670range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Commercial | $430 |
| ChoiceCare | Commercial | $503 |
| ChoiceCare | KY Medicaid HMO | $670 |
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All common services at Jackson-Madison County General Hospital