CT abdomen and pelvis with contrast at Bellville Medical Center. CPT 74177.
What Bellville Medical Center publishes for this service, straight from its standard-charges file, last updated June 1, 2026.
Outpatient / ER
$2,618cash price (self-pay)
$2,618list price
$285–$2,094range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Community Health | Medicare Advantage | $285 |
| Aetna Health Inc. | Medicare Advantage | $356 |
| Blue Cross Blue Sheild | Medicare Advantage PPO | $356 |
| Blue Cross Blue Sheild | Medicare Advantage HMO | $356 |
| Molina | Medicare Advantage | $356 |
| Scott & White | Medicare Advantage | $356 |
| Superior | Commericial | $356 |
| Superior | Medicare Advantage | $356 |
| TriWest | Medicare Advantage | $356 |
| United | Medicare Advantage | $356 |
| Community Health | Managed Medicaid | $369 |
| Amerigroup | Managed Medicaid | $462 |
| Molina | Managed Medicaid | $462 |
| Multiplan | Managed Medicaid | $462 |
| Scott & White | Managed Medicaid | $462 |
| Tesas Children's Health Plan | Managed Medicaid | $462 |
| United | Managed Medicaid | $462 |
| United | Commericial | $600 |
| Scott & White | Commericial | $650 |
| Blue Cross Blue Sheild | Essentials | $781 |
| Blue Cross Blue Sheild | Medicare Advantage | $781 |
| Blue Cross Blue Sheild | Traditional | $869 |
| Cigna | Commericial | $1,594 |
| HealthSmart | Commericial | $2,094 |
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