CT abdomen and pelvis with contrast at Glen Rose Medical Center. CPT 74177.
What Glen Rose Medical Center publishes for this service, straight from its standard-charges file.
Outpatient / ER
$1,953cash price (self-pay)
$1,953list price
$207–$1,855range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | Flexcare | $207 |
| Cigna | PPO | $207 |
| Cigna | HMO | $207 |
| Cook Children's | Health Plan Star | $898 |
| Aetna | HMO | $1,191 |
| Blue Cross Blue Shield | POS | $1,269 |
| Rightcare Scott and White | Commercial | $1,269 |
| Aetna | Non HMO | $1,367 |
| Aetna | PPO | $1,367 |
| Blue Cross Blue Shield | HMO | $1,426 |
| Scott and White | Texas HMO | $1,465 |
| Anthem Blue Cross | AmeriHealth HMO | $1,562 |
| Humana | Commercial HMO | $1,758 |
| Humana | PPO | $1,855 |
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