CT abdomen and pelvis with contrast at St. David's Surgical Hospital. CPT 74177.
What St. David's Surgical Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$1,749cash price (self-pay)
$1,749list price
$87.45–$2,739range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Superior Health Plan | CHIP | $87.45 |
| Superior Health Plan | CHPFC | $87.45 |
| Superior Health Plan | STAR | $87.45 |
| Superior Health Plan | STARPLUS | $87.45 |
| Superior Health Plan | AmbetterEPO | $297 |
| Superior Health Plan | AmbetterHMO | $297 |
| Superior Health Plan | ValueHMO | $297 |
| St David’s Hospice | MGMCD | $312 |
| Humana | MGMCD | $390 |
| Sendero | MCD | $390 |
| Aetna Better Health | MCD | $393 |
| United | OptionsPPO | $436 |
| Humana | HMO | $486 |
| Humana | PPO | $486 |
| BCBS | Traditional | $516 |
| United | NarrowNetworkHIX | $563 |
| Texas Workforce Commission | WCOMP | $682 |
| United | GlobalBenefitPlan | $787 |
| United | AllPayerAppendix | $828 |
| United | SmallGroup | $828 |
| BCBS | MyBlueHealth | $871 |
| Comanche County | LOCALGOV | $875 |
| Independent Medical Systems | COMM | $962 |
| BCBS | BlueAdvantage | $1,062 |
| National Health Care | COMM | $1,137 |
| First Health | PPO | $1,163 |
| Multiplan | PHCSPrimaryNetwork | $1,312 |
| BCBS | BlueEssentials | $1,470 |
| BCBS | BlueEssentialsAccess | $1,470 |
| Multiplan | ComplementaryNetwork | $1,487 |
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