CT abdomen and pelvis with contrast at Limestone Medical Center. CPT 74177.
What Limestone Medical Center publishes for this service, straight from its standard-charges file, last updated March 26, 2026.
Outpatient / ER
$2,763cash price (self-pay)
$4,605list price
$253–$3,684range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS PPO/Traditional | PPO/Traditional | $253 |
| BCBS HMO Blue Advantage | HMO | $253 |
| Texas Medicaid | UNKNOWN | $464 |
| WellMed Medicare Advantage | Medicare Advantage | $1,336 |
| United Health - Medicare Advantage | Medicare Advantage | $1,336 |
| BCBS Medicare Advantage | Medicare Advantage | $1,336 |
| Humana Medicare Advantage | Medicare Advantage | $1,336 |
| PPHP | Medicare Advantage | $1,362 |
| UHC Commercial | PPO/HMO | $2,846 |
| Cigna Commercial | PPO | $3,224 |
| Humana Commercial | PPO/HMO | $3,454 |
| Aetna Commercial | PPO/HMO | $3,684 |
Inpatient
$2,763cash price (self-pay)
$4,605list price
$2,846–$3,684range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UHC Commercial | PPO/HMO | $2,846 |
| Humana Commercial | PPO/HMO | $3,454 |
| Aetna Commercial | PPO/HMO | $3,684 |
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