CT abdomen and pelvis with contrast at Medical City Sachse Hospital. CPT 74177.
What Medical City Sachse Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$17,230cash price (self-pay)
$17,230list price
$341–$14,646range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United | NarrowNetworkIndivExchange | $341 |
| United | SmallGroup | $341 |
| Parkland Community Health Plan | MCD | $343 |
| Molina | CHIP | $346 |
| Molina | MCDSTAR | $346 |
| Molina | STAR+PLUS | $346 |
| Molina | STARKIDS | $346 |
| BCBS | BlueAdvantageHMO | $481 |
| BCBS | MyBlueHealth | $481 |
| Aetna | NewBusiness | $801 |
| United | AllPayerAppendix | $828 |
| Aetna | COMM | $856 |
| Aetna | Meritain | $856 |
| Aetna | OON | $1,013 |
| Superior Health Plan | CHIP | $1,206 |
| Superior Health Plan | MCDSTAR | $1,206 |
| Superior Health Plan | STARHealth | $1,206 |
| Superior Health Plan | STARKids | $1,206 |
| Superior Health Plan | STARPLUS | $1,206 |
| BCBS | BlueEssentials | $1,485 |
| BCBS | BlueEssentialsAccess | $1,485 |
| BCBS | Eposoa | $1,558 |
| BCBS | PPO | $1,631 |
| Cigna | IFP | $2,326 |
| Cigna | QHP | $2,412 |
| United | OptionsPPO | $2,912 |
| Healthcare Highways | CityofPlano | $5,824 |
| BCBS | Traditional | $7,133 |
| United | GlobalBenefitPlan | $7,754 |
| Aetna | ASA | $8,701 |
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