CT abdomen and pelvis with contrast at St. Luke's Health - Patients Medical Center. CPT 74177.

What St. Luke's Health - Patients Medical Center publishes for this service, straight from its standard-charges file, last updated February 28, 2026.

Outpatient / ER

$5,001cash price (self-pay)

$14,287list price

$296–$10,716range insurers pay

Insurance plan	Negotiated rate
CHC \| Medicaid\|All Plans	$296
TCHP \| Medicaid\|All Plans	$296
Wellpoint \| Medicaid\|All Plans	$312
UNITED \| Medicaid\|All Other Plans	$318
BCBS \| Medicare\|All Plans	$358
CIGNA-HEALTHSPRING \| Medicare\|All Plans	$358
HUMANA \| Medicare\|All Plans	$358
AETNA \| Medicare\|All Plans	$365
AMERIVANTAGE \| Medicare\|All Plans	$368
DEVOTED \| Medicare\|All Plans	$383
UNITED \| Medicaid\|STAR	$428
Cigna \| Commercial\|Surefit	$507
Ambetter \| Commercial\|All Plans	$537
Community Health Choice \| Commercial\|Exchange	$537
Wellpoint \| Commercial\|Exchange	$537
BCBS - TX \| Commercial\|MyBlue Health Exchange	$558
Cigna \| Commercial\|HMO	$559
Aetna \| Commercial\|Transplant	$590
Bright Health \| Commercial\|All Plans	$616
BCBS-TX \| Commercial\|Exchange	$649
Aetna \| Commercial\|PPO	$667
Humana \| Commercial\|HMO	$800
Humana \| Commercial\|PPO	$800
UNITED \| Medicaid\|STARPLUS	$974
BCBS-TX \| Commercial\|Blue Premier	$1,184
United \| Commercial\|Exchange	$1,315
Cigna \| Commercial\|PPO	$1,405
BCBS-TX \| Commercial\|HMO	$1,478
BCBS-TX \| Commercial\|PPO	$1,661
United \| Commercial\|Charter	$1,942

$5,001cash price (self-pay)

$14,287list price

$9,287–$10,716range insurers pay

Insurance plan	Negotiated rate
Coventry \| Commercial\|PPO	$9,287
First Health \| Commercial\|All Plans	$9,287
Cigna \| Commercial\|Transplant	$10,001
Healthsmart \| Commercial\|PPO	$10,001
MultiPlan \| Commercial\|All Plans	$10,716

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