CT abdomen and pelvis with contrast at Golden Plains Community Hospital. CPT 74177.
What Golden Plains Community Hospital publishes for this service, straight from its standard-charges file, last updated March 16, 2026.
Outpatient / ER
$5,949cash price (self-pay)
$8,498list price
$725–$5,524range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare Commercial | All Commercial | $725 |
| Blue Cross - Blue Advantage | HMO | $745 |
| Blue Cross Essentials HMO | HMO | $779 |
| Blue Cross PPO / Traditional | PPO/Traditional | $848 |
| Cigna | All Commercial | $1,564 |
| United Healthcare Medicare Advantage | Medicare Advantage | $1,955 |
| WellMed | Medicare Advantage | $1,955 |
| Aetna Medicare Advantage | Medicare Advantage | $1,955 |
| Humana Medicare Advantage | Medicare Advantage | $1,955 |
| Aetna | All Commercial | $5,524 |
Inpatient
$5,949cash price (self-pay)
$8,498list price
$5,099–$5,779range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross - Blue Advantage | HMO | $5,099 |
| Blue Cross Essentials HMO | HMO | $5,354 |
| Aetna | All Commercial | $5,524 |
| Blue Cross PPO / Traditional | PPO/Traditional | $5,779 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.