CT abdomen and pelvis with contrast at Cecil R Bomar Rehabilitation Center. CPT 74177.
What Cecil R Bomar Rehabilitation Center publishes for this service, straight from its standard-charges file.
Outpatient / ER
$1,067cash price (self-pay)
$5,557list price
$349–$7,558range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana | Medicare Advantage | $349 |
| WellMed | Medicare Advantage | $349 |
| HealthSpring | Medicare Advantage | $366 |
| United Healthcare | Commercial | $391 |
| HIET Benefit Plan | HIET | $1,945 |
| Blue Cross Blue Shield of Texas | Commercial | $3,057 |
| Blue Cross Blue Shield of Texas | PPO | $3,057 |
| Galaxy | PPO | $3,612 |
| USA Health Network | Commercial | $4,168 |
| Aetna | Commercial | $4,446 |
| Blue Cross Blue Shield of Texas | HMO | $4,446 |
| HealthSmart | Commercial | $4,446 |
| Phcs | PPO | $4,446 |
| Molina | Medicare Advantage | $5,557 |
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