CT abdomen and pelvis with contrast at Seymour Hospital. CPT 74177.
What Seymour Hospital publishes for this service, straight from its standard-charges file, last updated January 14, 2026.
Outpatient / ER
$1,576cash price (self-pay)
$2,251list price
$357–$1,801range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna - Medicare Advantage | Medicare Advantage | $357 |
| Triwest | Federal | $357 |
| Texas Medicaid | UNKNOWN | $464 |
| Amerigroup Medicaid | UNKNOWN | $464 |
| Firstcare Medicaid | UNKNOWN | $464 |
| Superior Health | Medicaid | $464 |
| Wellpoint Medicaid | UNKNOWN | $464 |
| Aetna Medicaid | UNKNOWN | $464 |
| United HMO/PPO | HMO/PPO | $850 |
| Geha | HMO/PPO/POS | $850 |
| Humana Medicare Advantage | Medicare Advantage | $1,463 |
| United Medicare Advantage | Medicare Advantage | $1,463 |
| Wellmed | Medicare Advantage | $1,463 |
| Aetna - Meritain | UNKNOWN | $1,576 |
| Aetna - HMO/PPO | HMO/PPO/POS | $1,576 |
| BCBS - HMO/PPO/Blue Advantage | HMO/PPO/Blue Advantage | $1,801 |
| Cigna - HMO/PPO | HMO/PPO | $1,801 |
| Galaxy Health Network | HMO/PPO/POS | $1,801 |
Inpatient
$1,576cash price (self-pay)
$2,251list price
$1,576–$2,251range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna - Meritain | UNKNOWN | $1,576 |
| Aetna - HMO/PPO | HMO/PPO/POS | $1,576 |
| BCBS - HMO/PPO/Blue Advantage | HMO/PPO/Blue Advantage | $1,801 |
| Cigna - HMO/PPO | HMO/PPO | $1,801 |
| Galaxy Health Network | HMO/PPO/POS | $1,801 |
| Aetna - Medicare Advantage | Medicare Advantage | $2,251 |
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