CT abdomen and pelvis with contrast at Hca Houston Tomball. CPT 74177.
What Hca Houston Tomball publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$33,494cash price (self-pay)
$33,494list price
$312–$28,470range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | MCDCHIPBH | $312 |
| Amerigroup | MGMCD | $312 |
| United | MGMCD | $324 |
| Aetna Better Health | MGMCD | $344 |
| United | NarrowNetworkIndivExchange | $699 |
| BCBS | MyBlueHealth | $821 |
| United | AllPayerAppendix | $828 |
| United | SmallGroup | $828 |
| BCBS | Bav | $947 |
| Aetna | NBHMO | $1,007 |
| Aetna | NBPOS | $1,007 |
| Aetna | NBPPO | $1,007 |
| Aetna | COMMHMO | $1,071 |
| Aetna | COMMPOS | $1,071 |
| Aetna | COMMPPO | $1,071 |
| Aetna | OONHMO | $1,258 |
| Aetna | OONPOS | $1,258 |
| Aetna | OONPPO | $1,258 |
| Aetna | ASAHMO | $1,361 |
| Aetna | ASAPOS | $1,361 |
| Aetna | ASAPPO | $1,361 |
| BCBS | HMO | $1,440 |
| BCBS | Eposoa | $1,577 |
| Cigna | CSN | $1,635 |
| Cigna | OpenAccessPlus | $1,771 |
| Superior Health Plan | CHIP | $2,010 |
| Superior Health Plan | CHPFC | $2,010 |
| Superior Health Plan | STAR | $2,010 |
| Superior Health Plan | STARKids | $2,010 |
| Superior Health Plan | STARPLUS | $2,010 |
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