CT abdomen and pelvis with contrast at Prisma Health Blount Memorial Hospital. CPT 74177.
What Prisma Health Blount Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 1, 2026.
Outpatient / ER
$1,597cash price (self-pay)
$5,153list price
$140–$4,792range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid Tn-Tenncare UHC Community Plan [3231] | Phtn Hb UHC Community | $140 |
| Medicaid Tn-Tenncare Bluecare [3230] | Phtn Hb Bluecare Of Tenn Medica | $257 |
| Medicaid Tn-Tenncare Wellpoint [3233] | Phtn Hb Wellpoint Medicaid - B | $288 |
| Humana Medicare Supplement [3091] | Phtn Hb Humana Medicare - Blount | $328 |
| Medicare BCBS [210] | Phtn Hb 100% Of Medicare - Blount | $328 |
| Medicare Humana [205] | Phtn Hb Humana Medicare - Blount | $328 |
| Medicare Wellcare [255] | Phtn Hb 100% Of Medicare - Blount | $328 |
| Medicare [200] | Phtn Hb Medicare - Blount | $331 |
| Medicare United Healthcare [230] | Phtn Hb UHC Medicare - Blount | $340 |
| Medicare BCBS [210] | Phtn Hb Bluecare Plus Medicare - Blount | $341 |
| Medicare Healthspring Fka Cigna [250] | Phtn Hb Healthspring Medicare | $341 |
| Medicare Wellpoint [256] | Phtn Hb Wellpoint Medicare - Blount | $341 |
| Cigna [2800] | Phtn Hb Cigna - Blount | $499 |
| Mvp Health Care [3037] | Phtn Hb Cigna - Blount | $499 |
| Ambetter Exchange-All States Contracted [4121] | Phtn Hb Ambetter Atc | $513 |
| Consociate Health Contracted [4835] | Phtn Hb Consociate Care Medicare | $729 |
| Fairos/Occunet Contracted [4837] | Phtn Hb Occunet Medicare - Blount | $762 |
| MEDICAID NC-AMERIHEALTH [3225] | PH North Carolina Medicaid | $794 |
| MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $794 |
| MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $794 |
| MEDICAID NC-UHC COMMUNITY PLAN [3226] | PH North Carolina Medicaid | $794 |
| MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $794 |
| MEDICAID NORTH CAROLINA [310] | PH North Carolina Medicaid | $794 |
| Cigna [2800] | Phtn Hb Blount County Govt - Blount | $800 |
| BCBS [800] | Phtn Hb BCBS Of Tenn - Blount | $811 |
| All Savers - UHC [2980] | Phtn Hb United Healthcare All Payer - Blount | $859 |
| Bind-Surest Benefits On Demand-UHC [2972] | Phtn Hb United Healthcare | $859 |
| Golden Rule Insurance Company [2991] | Phtn Hb United Healthcare All P | $859 |
| BOB JONES UNIV-PAI [821] | GHS HB MyHFN BOB JONES PAI | $1,840 |
| Medcost [2940] | Ph Hb Medcost Benefit Services | $3,813 |
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All common services at Prisma Health Blount Memorial Hospital