CT abdomen and pelvis with contrast at Baylor Scott & White Mclane Children's Medical Center. CPT 74177.
What Baylor Scott & White Mclane Children's Medical Center publishes for this service, straight from its standard-charges file, last updated June 13, 2026.
Outpatient / ER
$3,807cash price (self-pay)
$6,345list price
$312–$4,759range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Superior Health Plan | Medicaid | $312 |
| Baylor Scott & White Health Plan | Medicare Advantage | $333 |
| United Healthcare | Medicaid/CHIP | $334 |
| CORVEL | Worker's Compensation | $340 |
| TriWest | Community Care Network | $350 |
| American Health Plan | Medicare Advantage | $368 |
| Blue Cross Blue Shield | Medicare Advantage | $368 |
| ProCare Advantage | Medicare Advantage | $368 |
| United Healthcare | Medicare Advantage | $393 |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | $421 |
| Baylor Scott & White Health Plan | BSW Premier - Individual | $440 |
| Prime Health Services | Worker's Compensation | $442 |
| CareWorks fka Rockport | Worker's Compensation | $524 |
| Sedgwick | Preferred Network | $524 |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | $578 |
| Mark Cuban | Commercial | $953 |
| Imagine Health | Commercial | $1,454 |
| Cigna | Local Plus | $1,466 |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premi | $1,480 |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My Blue | $1,596 |
| Blue Cross Blue Shield | Blue Advantage | $1,615 |
| Cigna | HMO/PPO | $1,725 |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier | $1,742 |
| University of Mary Hardin-Baylor | Commercial | $1,841 |
| Blue Cross Blue Shield | Blue Essentials (HMO) | $1,848 |
| Blue Cross Blue Shield | BlueChoice (PPO) | $1,947 |
| United Healthcare | Commercial | $1,997 |
| Employers Health Network | BSWQA Direct/EHN Rental | $2,982 |
| Aetna | Commercial | $3,490 |
| QuikTrip | Employee Benefit Plan | $3,490 |
Inpatient
$3,807cash price (self-pay)
$6,345list price
$3,490–$4,441range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| QuikTrip | Employee Benefit Plan | $3,490 |
| MidCoast | Commercial | $3,490 |
| Independent Medical System | Commercial PPO | $3,807 |
| Curative | Commercial | $4,124 |
| First Health | PPO | $4,441 |
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All common services at Baylor Scott & White Mclane Children's Medical Center