CT abdomen and pelvis with contrast at St David's Medical Center. CPT 74177.
What St David's Medical Center publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$7,076cash price (self-pay)
$7,076list price
$270–$6,368range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | CHIP | $270 |
| Amerigroup | MCD | $270 |
| United | MGMCD | $324 |
| Superior Health Plan | CHIP | $354 |
| Superior Health Plan | CHPFC | $354 |
| Superior Health Plan | STAR | $354 |
| Superior Health Plan | STARPLUS | $354 |
| Aetna Better Health | MCD | $393 |
| United | NarrowNetworkHIX | $563 |
| United | AllPayerAppendix | $828 |
| United | SmallGroup | $828 |
| BCBS | BlueAdvantage | $1,062 |
| Superior Health Plan | AmbetterEPO | $1,203 |
| Superior Health Plan | AmbetterHMO | $1,203 |
| Superior Health Plan | ValueHMO | $1,203 |
| BCBS | BlueEssentials | $1,470 |
| United | OptionsPPO | $1,762 |
| Humana | HMO | $1,966 |
| Humana | PPO | $1,966 |
| IMO Med - Select Network | WC | $2,123 |
| BCBS | Traditional | $2,257 |
| Texas Healthcare Foundation HEB | COMM | $2,618 |
| Texas Healthcare Foundation HEB | WC | $2,618 |
| Texas Workforce Commission | WCOMP | $2,760 |
| United | GlobalBenefitPlan | $3,184 |
| Comanche County | LOCALGOV | $3,538 |
| National ChoiceCare | WC | $3,538 |
| HealthSmart Preferred Care | Accel | $3,892 |
| Independent Medical Systems | COMM | $3,892 |
| Physicians Cooperative of Texas | WC | $3,892 |
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