CT abdomen and pelvis with contrast at WTH Dyersburg Hospital. CPT 74177.
What WTH Dyersburg Hospital publishes for this service, straight from its standard-charges file, last updated June 2, 2026.
Outpatient / ER
$201cash price (self-pay)
$670list price
$150–$670range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| River Valley Plan | TennCare | $150 |
| Aetna | VHAN - Employee Networks | $312 |
| Veterans Affairs | Community Care Network | $317 |
| Blue Cross Blue Shield of Tennessee | BlueCare | $326 |
| Aetna | Whole Health | $328 |
| Aetna | New Business Discount - Commercial | $342 |
| Cigna | HMO/Network/Open Access Plus | $358 |
| Cigna | IFP/LocalPlus | $358 |
| Blue Cross Blue Shield of Tennessee | Network P | $398 |
| Blue Cross Blue Shield of Tennessee | Network S/E | $398 |
| Aetna | Commercial | $430 |
| Celtic Insurance Company | Commercial-Exchange | $491 |
| Oscar | HMO/Medicare Advantage/PPO/EPO/POS | $650 |
| Home State Health Plan | MO HealthNet Medicaid | $670 |
Inpatient
$201cash price (self-pay)
$670list price
$342–$670range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | New Business Discount - Commercial | $342 |
| Aetna | Commercial | $430 |
| Home State Health Plan | MO HealthNet Medicaid | $670 |
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