CT abdomen and pelvis with contrast at Carilion Rockbridge Community Hospital. CPT 74177.
What Carilion Rockbridge Community Hospital publishes for this service, straight from its standard-charges file, last updated December 15, 2025.
Outpatient / ER
$1,542cash price (self-pay)
$4,406list price
$279–$4,186range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Healthkeeper Plus | Managed Medicaid | $279 |
| Sentara Health Plan | Managed Medicaid | $284 |
| Humana Medicaid | Managed Medicaid | $292 |
| ABH of WVA (formerly Coventry) | Managed Medicaid | $292 |
| United Healthcare - Medicaid | Managed Medicaid | $292 |
| ABH of VA (formerly Coventry) | Managed Medicaid | $292 |
| Aetna - Medicare Prime | Medicare Advantage | $306 |
| Humana - Dual Eligible | Dual Eligible | $319 |
| Anthem - Medicare Advantage | Medicare Advantage | $332 |
| Humana | Medicare Advantage | $332 |
| United Healthcare - Medicare | Medicare Advantage | $336 |
| Aetna - Medicare | Medicare Advantage | $336 |
| Sentara Health Plan | Medicare Advantage | $342 |
| Humana Military | Tricare | $355 |
| Anthem - Exchange | Exchange | $1,465 |
| Anthem - PPO PAR HMO | Commercial | $1,628 |
| United Healthcare - RCPS | Commercial | $2,207 |
| Aetna - Preferred | Commercial | $2,243 |
| Aetna | Choice POS II | $2,282 |
| Gateway - Tier 3 | Commercial | $2,423 |
| United Healthcare - Non Option PPO | Commercial | $2,519 |
| Sentara Health Plan | Commercial | $2,732 |
| VHN - ULTRA | Commercial | $2,732 |
| Aetna - BoB | Commercial | $2,926 |
| Connecticare | Commercial | $3,084 |
| United Healthcare - Options PPO | Commercial | $3,175 |
| Gateway - Tier 2 | Commercial | $3,525 |
| VHN - PLUS | Commercial | $3,525 |
| Cigna - PPO | Commercial | $3,529 |
| Cigna - HMO | Commercial | $3,529 |
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All common services at Carilion Rockbridge Community Hospital