CT abdomen and pelvis with contrast at Pipeline East Dallas LLC. CPT 74177.
What Pipeline East Dallas LLC publishes for this service, straight from its standard-charges file, last updated May 22, 2026.
Outpatient / ER
$5,386cash price (self-pay)
$7,920list price
$312–$5,702range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | CHIP/Medicaid | $312 |
| Amerigroup | Dual Medicare/Medicaid | $350 |
| Amerigroup | Medicare | $350 |
| BCBS of TX | Medicare | $350 |
| Cigna | Medicare | $350 |
| Employer Direct | Commercial | $350 |
| Humana | Medicare/TRICARE | $350 |
| Molina | Dual Medicare/Medicaid | $350 |
| Molina | Medicare | $350 |
| Scott and White | Medicare | $350 |
| Superior Health Plan | EPO | $350 |
| Superior Health Plan | Medicare | $350 |
| Universal American | Dual Medicare/Medicaid | $350 |
| Universal American | Medicare | $350 |
| Wellcare | Medicare | $350 |
| Wellmed | Medicare | $350 |
| Scott and White | EPO/PPO | $385 |
| BCBS of TX | Blue Advantage | $630 |
| Cigna | Commercial | $741 |
| BCBS of TX | Blue Essentials | $756 |
| BCBS of TX | PPO | $844 |
| Multiplan | Auto | $5,148 |
| Multiplan | Commercial | $5,148 |
| Multiplan | Workers Comp | $5,148 |
| Cigna | Medicaid | $5,702 |
| Molina | CHIP/Medicaid | $5,702 |
| Parkland | Medicaid | $5,702 |
| Superior Health Plan | CHIP/Medicaid | $5,702 |
Inpatient
$5,386cash price (self-pay)
$7,920list price
—range insurers pay
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