CT abdomen and pelvis with contrast at Hendrick Medical Center. CPT 74177.
What Hendrick Medical Center publishes for this service, straight from its standard-charges file, last updated October 1, 2026.
Outpatient / ER
$5,991cash price (self-pay)
$11,982list price
$328–$10,664range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| FirstCare Star | Managed Medicaid | $328 |
| Superior Health Plan | Managed Medicaid/CHIP | $375 |
| Wellpoint (Formerly Known as Amerigroup) | Managed Medicaid/CHIP | $375 |
| Blue Cross Blue Shield of Texas | Marketplace | $1,214 |
| Blue Cross Blue Shield of Texas | HMO | $1,287 |
| Blue Cross Blue Shield of Texas | PPO | $1,428 |
| Baylor Scott and White Health Plan | Commercial | $3,391 |
| UMR Hendrick Employee Plan | Commercial | $4,673 |
| United Healthcare | Commercial | $4,745 |
| Blue Cross Blue Shield of Texas | Traditional | $5,033 |
| Cigna | Commercial | $6,590 |
| Aetna | Commercial | $7,549 |
| Healthsmart | Commercial | $8,987 |
| Private Healthcare Systems | Commercial | $9,586 |
| Omni Networks | Commercial | $10,185 |
| MultiPlan | Commercial | $10,664 |
Inpatient
$5,991cash price (self-pay)
$11,982list price
$2,157–$10,664range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross Blue Shield of Texas | Marketplace | $2,157 |
| Blue Cross Blue Shield of Texas | HMO | $2,396 |
| Blue Cross Blue Shield of Texas | PPO | $2,516 |
| Baylor Scott and White Health Plan | Commercial | $3,391 |
| United Healthcare | Commercial | $4,805 |
| Blue Cross Blue Shield of Texas | Traditional | $5,033 |
| UMR Hendrick Employee Plan | Commercial | $6,590 |
| Aetna | Commercial | $7,549 |
| Private Healthcare Systems | Commercial | $7,788 |
| Omni Networks | Commercial | $8,987 |
| MultiPlan | Commercial | $10,664 |
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