CT abdomen and pelvis with contrast at Rolling Plains Memorial Hospital. CPT 74177.
What Rolling Plains Memorial Hospital publishes for this service, straight from its standard-charges file.
Outpatient / ER
$3,028cash price (self-pay)
$4,658list price
$3,261–$3,959range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana (Choice Care) | Commercial | $3,261 |
| United Healthcare | Commercial | $3,521 |
| Blue Cross and Blue Shield | HMO | $3,726 |
| Blue Cross and Blue Shield | PPO | $3,726 |
| Blue Cross and Blue Shield | Traditional | $3,726 |
| Cigna | Commercial | $3,754 |
| Aetna | Commercial | $3,959 |
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