CT abdomen and pelvis with contrast at Medina Regional Hospital. CPT 74177.
What Medina Regional Hospital publishes for this service, straight from its standard-charges file, last updated July 29, 2026.
Outpatient / ER
$3,187cash price (self-pay)
$3,541list price
$400–$3,541range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | Commercial | $400 |
| Aetna | Managed Medicaid | $464 |
| Amerigroup | CHIP/Managed Medicaid | $464 |
| Superior Health Plan | Managed Medicaid | $464 |
| Amerigroup | Star Plus | $464 |
| Community First Health Plan | CHIP | $487 |
| Benefit Administrators | Commercial | $627 |
| Medicare | Medicare | $850 |
| United Healthcare | Medicare Advantage | $850 |
| Superior Health Plan | Medicare Advantage | $867 |
| Curative | Commercial EPO/PPO | $916 |
| Community First Health Plan | HIE | $1,062 |
| Wellpoint | Commercial | $1,147 |
| Amerivantage | Medicare Advantage | $1,169 |
| Blue Cross Blue Shield of Texas | Traditional/PPO/Blue Essentitals | $1,195 |
| Aetna | Medicare Advantage | $1,239 |
| Superior Health Plan | Commercial HMO/EPO | $1,372 |
| Blue Advantage | HMO | $1,771 |
| Aetna | Commercial | $2,125 |
| Community First Health Plan | Managed Medicaid | $2,479 |
| United Healthcare | Commercial | $2,656 |
| Community First Health Plan | HMO | $3,541 |
Inpatient
$3,187cash price (self-pay)
$3,541list price
$627–$3,187range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Benefit Administrators | Commercial | $627 |
| Blue Advantage | HMO | $1,771 |
| Curative | Commercial EPO/PPO | $2,125 |
| Community First Health Plan | HMO | $3,187 |
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