CT abdomen and pelvis with contrast at Stephens Memorial Hospital. CPT 74177.
What Stephens Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 24, 2026.
Outpatient / ER
$2,005cash price (self-pay)
$2,864list price
$464–$3,612range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina Medicaid | HMO | $464 |
| Aetna Better Health Medicaid | HMO | $464 |
| Superior Medicaid | HMO | $464 |
| Firstcare Medicaid | HMO | $464 |
| UHC Medicaid Replacement | HMO | $464 |
| Amerigroup Medicaid | HMO | $464 |
| UHC Contract - HMO/PPO/POS | HMO/PPO/POS | $750 |
| United Healthcare Medicare Advantage | Medicare Advantage | $1,031 |
| Blue Cross HMO | HMO | $1,184 |
| Blue Cross PPO/POS | PPO/POS | $1,436 |
| Blue Cross Traditional | Traditional | $1,508 |
| Humana Medicare Advantage | Medicare Advantage | $1,548 |
| Blue Advantage HMO | Advantage HMO | $1,566 |
| Cigna - HMO/PPO/POS | HMO/PPO/POS | $2,034 |
| Aetna - HMO/PPO/POS | HMO/PPO/POS | $3,612 |
Inpatient
$2,005cash price (self-pay)
$2,864list price
$2,034–$3,440range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna - HMO/PPO/POS | HMO/PPO/POS | $2,034 |
| Blue Cross PPO/POS | PPO/POS | $2,292 |
| Blue Cross Traditional | Traditional | $2,292 |
| Blue Cross HMO | HMO | $3,440 |
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