CT abdomen and pelvis with contrast at Wayne Medical Center. CPT 74177.
What Wayne Medical Center publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$1,708cash price (self-pay)
$4,166list price
$156–$3,749range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS of Tennessee | Medicaid | $269 |
| BCBS of Tennessee | TennCare Select | $326 |
| Humana Military | Tricare | $342 |
| Ambetter | Commercial Exchange | $379 |
| American Health Plans | Medicare Advantage | $379 |
| Cigna | Medicare Advantage | $379 |
| Humana | Medicare Advantage | $379 |
| Medicare | Medicare | $379 |
| Oscar | Commercial Exchange | $379 |
| UnitedHealthcare | Dual Special Needs | $379 |
| UnitedHealthcare | Veterans Affairs | $379 |
| Wellpoint | Medicare Advantage | $379 |
| UnitedHealthcare | Medicare Advantage | $387 |
| Aetna | Medicare Advantage | $390 |
| NHC | Medicare Advantage | $390 |
| Wellcare Harmony Health | Medicare Advantage | $390 |
| BCBS of Tennessee | Dual Special Needs | $392 |
| BCBS of Tennessee | Medicare Advantage | $392 |
| Wellpoint | Medicaid | $448 |
| ClaimDOC | Commercial | $910 |
| Partners Direct Health | Commercial | $910 |
| UnitedHealthcare | Medicaid | $1,629 |
| BCBS of Tennessee | Commercial Network P | $1,875 |
| BCBS of Tennessee | Commercial Network S | $1,875 |
| UnitedHealthcare | Commercial | $2,041 |
| Wayne County Jail | Commercial | $2,083 |
| Cigna | Commercial | $2,220 |
| Aetna | Whole Health & VHAN | $2,600 |
| Lewis County Jail | Commercial | $3,125 |
| Marshall County Jail | Commercial | $3,125 |
Inpatient
$1,708cash price (self-pay)
$4,166list price
$2,083–$4,166range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wayne County Jail | Commercial | $2,083 |
| Lewis County Jail | Commercial | $3,125 |
| Marshall County Jail | Commercial | $3,125 |
| Aetna | Commercial | $3,749 |
| Aetna | Medicare Advantage | $4,166 |
| Humana | Medicare Advantage | $4,166 |
| Medicare | Medicare | $4,166 |
| Tennessee Carriers, Inc. | Medicaid | $4,166 |
| UnitedHealthcare | Dual Special Needs | $4,166 |
| UnitedHealthcare | Veterans Affairs | $4,166 |
| Wellpoint | Medicaid | $4,166 |
| Wellpoint | Medicare Advantage | $4,166 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.