CT abdomen and pelvis with contrast at Jefferson Memorial Hospital. CPT 74177.
What Jefferson Memorial Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$2,082cash price (self-pay)
$9,408list price
$98.85–$9,408range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| TN Medicaid Non-Par | TN Medicaid Non-Par | $98.85 |
| United Healthcare | UHC Community Plan | $98.85 |
| Amerigroup | Amerigroup Community Care | $184 |
| BlueCare | BCBS TN BlueCare | $193 |
| BlueCare | BCBS TN TennCare Select | $193 |
| BlueCare | BCBS TN CoverKids | $209 |
| NODE Tricare | NODE Tricare | $301 |
| Humana | NODE Humana MCR ADV | $311 |
| NODE Medicare Non Par | NODE Medicare Non Par | $311 |
| NODE Medicare Traditional | NODE Medicare Traditional | $311 |
| Node UHC Mcr Adv | Node UHC Mcr Adv | $311 |
| NODE ChampVA | NODE ChampVA | $317 |
| NODE BlueCare Plus TN MCR ADV | NODE BlueCare Plus TN MCR ADV | $317 |
| NODE Hospice Non Par Agree | NODE Hospice Non Par | $317 |
| NODE United Optum VA CCN | NODE United Optum VA CCN | $317 |
| Node Va | Node Va | $317 |
| NODE Devoted Health MCR ADV | NODE Devoted Health MCR ADV | $318 |
| NODE Farm Bureau MCR ADV | NODE Farm Bureau MCR ADV | $318 |
| Veterans Eval Services | Veterans Eval Services | $320 |
| NODE Aetna MCR ADV | NODE Aetna MCR ADV | $321 |
| Node BCBS Mcr Adv | Node BCBS Mcr Adv | $321 |
| NODE Healthspring MCR ADV | NODE Healthspring MCR ADV | $321 |
| NODE Amerigroup MCR ADV | NODE Amerigroup MCR ADV | $327 |
| United Healthcare | NODE UHC MCR Dual ADV | $327 |
| NODE Wellcare MCR ADV | NODE Wellcare MCR ADV | $329 |
| Node Nhc Mcr Adv | Node Nhc Mcr Adv | $343 |
| NODE US Dept of Labor | NODE US Dept of Labor | $396 |
| BCBS TN | BCBS TN Net S | $421 |
| Cigna | Cigna ALL | $456 |
| BCBS TN | BCBS TN Net P | $526 |
Inpatient
$2,082cash price (self-pay)
$9,408list price
$1,910–$9,408range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CHS Group Health Plan BCBST | CHS Group Health Plan BCBST | $1,910 |
| Multiplan Complementary | Multiplan Complementary | $7,432 |
| United Healthcare | UHC APA | $9,408 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.