CT abdomen and pelvis with contrast at Nacogdoches Memorial Hospital. CPT 74177.
What Nacogdoches Memorial Hospital publishes for this service, straight from its standard-charges file.
Outpatient / ER
$189cash price (self-pay)
$3,556list price
$347–$7,558range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana | Medicare Advantage | $349 |
| WellMed | Medicare Advantage | $349 |
| HealthSpring | Medicare Advantage | $366 |
| Molina | Medicare Advantange | $366 |
| United Healthcare | Commercial | $391 |
| Blue Cross Blue Shield of Texas | PPO | $1,956 |
| Blue Cross Blue Shield of Texas | Commercial | $1,956 |
| Galaxy | PPO | $2,311 |
| USA Health Network | Commercial | $2,667 |
| Aetna | Commercial | $2,845 |
| Blue Cross Blue Shield of Texas | HMO | $2,845 |
| HealthSmart | Commercial | $2,845 |
| Phcs | PPO | $2,845 |
| HIET Benefit Plan | HIET | $3,556 |
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