CT abdomen and pelvis with contrast at Methodist Midlothian Medical Center. CPT 74177.
What Methodist Midlothian Medical Center publishes for this service, straight from its standard-charges file, last updated March 21, 2026.
Outpatient / ER
$2,601cash price (self-pay)
$8,670list price
$296–$8,670range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare Medicaid Managed Care [5015] | Mhs Hb United Medicai | $296 |
| Ust Health Proof [1005] | Mhs Hb UHC Medicare Complete Mlmc | $350 |
| United Healthcare Medicare Managed Care [3044] | Mhs Hb UHC Medicare C | $350 |
| Covid19 Hrsa Uninsured Testing And Treatment Fund [6005] | Mhs Hb Unin | $350 |
| Aetna Medicare Managed Care [7000] | Mhs Hb Aetna Golden Mlmc | $350 |
| BCBS Medicare Managed Care [7002] | Mhs Hb BCBS Medicare Advantage Mlm | $350 |
| Generic Medicare Managed Care [7004] | Mhs Hb Managed Medicare Part A | $350 |
| Globalhealth [1003] | Mhs Hb Global Health Mlmc | $368 |
| Care N Care Medicare Managed Care [7003] | Mhs Hb Scott And White Medi | $368 |
| Molina Medicare Managed Care [7007] | Mhs Hb Molina Medicare Mlmc | $368 |
| Humana Commercial [2051] | Mhs Hb Humana Medicare Mlmc | $371 |
| Wellpoint Medicare Managed Care [7001] | Mhs Hb Managed Medicare 106% | $371 |
| BCBS Medicare Managed Care [7002] | Mhs Hb Managed Medicare 106% Mlmc | $371 |
| Humana Medicare Managed Care [7005] | Mhs Hb Humana Medicare Mlmc | $371 |
| United Healthcare Managed Care [3021] | Mhs Hb UHC Exchange Mlmc | $375 |
| Oscar Insurance Company [2057] | Mhs Hb Oscar HMO Mlmc | $456 |
| Bright Healthcare [2222] | Mhs Hb Bright Health Mlmc | $491 |
| Friday Health Plan [2061] | Mhs Hb Friday Health Mlmc | $500 |
| Molina [3017] | Mhs Hb Molina Marketplace Mlmc | $508 |
| Wellpoint Marketplace Exchange [3071] | Mhs Hb Wellpoint Texas Essenti | $543 |
| Kempton Group Administrators, Tower Extrusions [3061] | Mhs Hb Tower E | $561 |
| Aetna [3000] | Mhs Hb Aetna Exchange Mlmc | $568 |
| Aetna [3000] | Mhs Hb Aetna Cvs Mlmc | $568 |
| Allied National [2031] | Mhs Hb 90 Degree Mlmc | $578 |
| Entrust/90 Degree [2058] | Mhs Hb 90 Degree Mlmc | $578 |
| 90 Degree Benefit [3057] | Mhs Hb 90 Degree Mlmc | $578 |
| Ambetter Superior [3051] | Mhs Hb Ambetter Superior Mlmc | $599 |
| Imperial Insurance Companies [3073] | Mhs Hb Imperial Managed Care Mlm | $631 |
| Cigna [3004] | Mhs Hb Custom Ink Mlmc | $648 |
| Web Tpa [3049] | Mhs Hb Custom Ink Mlmc | $648 |
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