CT abdomen and pelvis with contrast at Pampa Regional Medical Center. CPT 74177.
What Pampa Regional Medical Center publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$1,353cash price (self-pay)
$7,121list price
$139–$5,697range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Coventry FKA Aetna Workers Compensation | $139 |
| Texas Blue Bonnet Health Plan | Texas Blue Bonnet Health Plan Medicare | $142 |
| Tricare | Tricare | $142 |
| Triwest ( BCBS ) | Triwest BCBS | $142 |
| Molina | Molina Medicare Advantage | $149 |
| PROVIDER PARTNERS HEALTH PLAN | Provider Partners Health Plan Medicare | $149 |
| Imperial Insurance Companies | Imperial Insurance Companies | $150 |
| Employer Direct Healthcare | Employer Direct Healthcare | $199 |
| Corporate Remedies (WC) | Corporate Remedies Workers Compensation | $213 |
| United Healthcare | UHC Commercial Exchange | $213 |
| Molina | Molina Insurance Exchange | $234 |
| Texas Blue Bonnet Health Plan | Texas Blue Bonnet Health Plan Commerci | $234 |
| BCBS | BCBS HMO Advantage | $332 |
| Traditional Medicaid | Traditional Medicaid | $462 |
| United Healthcare | UHC Commercial All Payor | $468 |
| Amerigroup | Amerigroup Medicaid | $476 |
| BCBS | BCBS Medicaid | $476 |
| Superior Health Plan | Superior Health Plan STAR Medicaid | $476 |
| Molina | Molina STAR Medicaid | $504 |
| Superior Health Plan | Superior Health Plan STAR KIDS | $600 |
| Superior Health Plan | Superior Health Plan STAR PLUS Medicaid | $628 |
| Molina | Molina STAR PLUS Medicaid | $666 |
| BCBS | BCBS HMO | $1,543 |
| BCBS | BCBS PPO | $1,715 |
| BCBS | BCBS Traditional | $1,715 |
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