CT abdomen and pelvis with contrast at Methodist Southlake Medical Center. CPT 74177.
What Methodist Southlake Medical Center publishes for this service, straight from its standard-charges file, last updated March 23, 2026.
Outpatient / ER
$2,601cash price (self-pay)
$8,670list price
$296–$8,670range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Champva [1000] | Mhs Hb Tricare Msmc | $341 |
| Tricare [1001] | Mhs Hb Tricare Msmc | $341 |
| Ust Health Proof [1005] | Mhs Hb UHC Medicare Complete Msmc | $351 |
| United Healthcare Medicare Managed Care [3044] | Mhs Hb UHC Medicare C | $351 |
| Globalhealth [1003] | Mhs Hb Global Health Msmc | $369 |
| Humana Commercial [2051] | Mhs Hb Humana Medicare Msmc | $372 |
| United Healthcare Managed Care [3021] | Mhs Hb UHC Exchange Msmc | $376 |
| Oscar Insurance Company [2057] | Mhs Hb Oscar HMO Msmc | $456 |
| Bright Healthcare [2222] | Mhs Hb Bright Health Msmc | $491 |
| Friday Health Plan [2061] | Mhs Hb Friday Health Msmc | $500 |
| Molina [3017] | Mhs Hb Molina Marketplace Msmc | $509 |
| Aetna [3000] | Mhs Hb Aetna Exchange Msmc | $569 |
| Aetna [3000] | Mhs Hb Aetna Cvs Msmc | $569 |
| Allied National [2031] | Mhs Hb 90 Degree Msmc | $579 |
| Entrust/90 Degree [2058] | Mhs Hb 90 Degree Msmc | $579 |
| Cigna [3004] | Mhs Hb Custom Ink Msmc | $649 |
| Evry Health [1013] | Mhs Hb Evry Msmc | $702 |
| Bind Benefits Inc [1004] | Mhs Hb United Healthcare Msmc | $908 |
| United Healthcare-Commercial [2026] | Mhs Hb United Healthcare Msmc | $908 |
| Freedom Life Insurance Company [2029] | Mhs Hb United Healthcare Msmc | $908 |
| United Healthcare-Managed Care [2067] | Mhs Hb United Healthcare Msmc | $908 |
| Definity Health [3006] | Mhs Hb United Healthcare Msmc | $908 |
| United Healthcare Managed Care [3021] | Mhs Hb United Healthcare Msmc | $908 |
| Healthscope Benefits [2052] | Mhs Hb Dart Member Care Msmc | $948 |
| Dart Member Care [3039] | Mhs Hb Dart Member Care Msmc | $948 |
| Aetna Commercial [2042] | Mhs Hb Aetna TX Pref Plus II Msmc | $1,204 |
| Aetna Managed Care [2068] | Mhs Hb Aetna TX Pref Plus II Msmc | $1,204 |
| Aetna Commercial [2042] | Mhs Hb Aetna Texas Advantage Msmc | $1,300 |
| Aetna Managed Care [2068] | Mhs Hb Aetna Whole Health Msmc | $1,300 |
| Aetna Managed Care [2068] | Mhs Hb Aetna Texas Advantage Msmc | $1,300 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.