CT abdomen and pelvis with contrast at Medical City Spine Hospital. CPT 74177.
What Medical City Spine Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$10,325cash price (self-pay)
$10,325list price
$307–$10,325range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Texas Health Network | Mcd | $307 |
| Amerigroup | CHIP | $312 |
| Amerigroup | MGMCD | $312 |
| Cook Childrens Health Plan | CHIP | $312 |
| Cook Childrens Health Plan | STAR | $312 |
| Parkland Community Health Plan | MCD | $312 |
| United | CHIP | $312 |
| United | STAR | $312 |
| United | STARKids | $312 |
| United | STARPerinate | $312 |
| United | STARPLUS | $312 |
| Cigna Healthspring | MGMCD | $328 |
| Aetna Better Health | CHIP | $337 |
| Aetna Better Health | MCD | $337 |
| United | NarrowNetworkIndivExchange | $341 |
| United | SmallGroup | $341 |
| Molina | CHIP | $346 |
| Molina | MCDSTAR | $346 |
| Molina | STAR+PLUS | $346 |
| Molina | STARKIDS | $346 |
| Humana | MGMCD | $390 |
| BCBS | BlueAdvantageHMO | $481 |
| BCBS | MyBlueHealth | $481 |
| Aetna | NewBusiness | $801 |
| United | AllPayerAppendix | $828 |
| Aetna | COMM | $856 |
| Aetna | Meritain | $856 |
| Aetna | OON | $1,013 |
| Cigna | IFP | $1,394 |
| Cigna | QHP | $1,445 |
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