CT abdomen and pelvis with contrast at WTH Henry County Hospital. CPT 74177.
What WTH Henry County Hospital publishes for this service, straight from its standard-charges file, last updated June 2, 2026.
Outpatient / ER
$4,023cash price (self-pay)
$4,023list price
$269–$2,615range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | TennCare Medicaid | $269 |
| Amerigroup | Medicare Advantage | $317 |
| Blue Cross Blue Shield of Tennessee | BlueCare Plus | $317 |
| Harmony Health Plan | Medicare Advantage | $317 |
| Humana | Medicare Advantage PPO | $323 |
| Aetna | Medicare Advantage | $326 |
| American Health Plan | Medicare Advantage | $326 |
| Blue Cross Blue Shield of Tennessee | BlueAdvantage PPO | $326 |
| Cigna-HealthSpring | Medicare Advantage | $326 |
| River Valley Plan | SNP | $326 |
| Tennessee Rural Health Improvement Association | Medicare Advantage Pr | $326 |
| Windsor Health Plan | Medicare Extra | $326 |
| Cigna | HMO/Network/Open Access Plus | $358 |
| Cigna | IFP/LocalPlus | $358 |
| Ambetter | Commercial-Exchange | $633 |
| Celtic Insurance Company | Commercial-Exchange | $633 |
| Oscar | HMO/Medicare Advantage/PPO/EPO/POS | $650 |
| River Valley Plan | TennCare | $1,609 |
| Aetna | Commercial | $2,615 |
Inpatient
$4,023cash price (self-pay)
$4,023list price
$1,609–$1,609range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| River Valley Plan | TennCare | $1,609 |
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