CT abdomen and pelvis with contrast at Ochiltree General Hospital. CPT 74177.
What Ochiltree General Hospital publishes for this service, straight from its standard-charges file.
Outpatient / ER
$430cash price (self-pay)
$1,871list price
$82.00–$2,815range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Advantage | $808 |
| Humana | Medicare Advantage | $808 |
| Superior Health Plan | Commercial | $808 |
| Aetna | Commercial | $1,591 |
| Blue Cross Blue Shield of Texas | PPO | $1,684 |
| Blue Cross Blue Shield of Texas | Commercial | $1,684 |
| Cigna | Commercial | $1,684 |
| FirstCare | Commercial | $1,684 |
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