CT abdomen and pelvis with contrast at Dickenson Community Hospital. CPT 74177.
What Dickenson Community Hospital publishes for this service, straight from its standard-charges file, last updated March 23, 2026.
Outpatient / ER
$549cash price (self-pay)
$2,388list price
$237–$2,388range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross | Blue Cross Ballad Health Employee | $237 |
| Cigna Healthcare | Cigna Individual Family Plan | $427 |
| Cigna Healthcare | Cigna HMO | $498 |
| Cigna Healthcare | Cigna Open Access Plus | $498 |
| United Healthcare | Tenncare United Healthcare | $522 |
| Cigna Healthcare | Cigna PPO | $542 |
| Optima Health | Optima Health Medicaid | $583 |
| United Healthcare | United Healthcare Medicaid Virginia | $583 |
| Blue Cross | Anthem Hlthkeep Mediciad | $601 |
| Molina Healthcare | Molina Healthcare Medicaid | $606 |
| Aetna | Aetna Better Health Of Virginia | $606 |
| Aetna | Aetna Healthcare Medicare | $716 |
| Allcare Medicare | Allcare Medicare | $716 |
| Amerigroup | Amerigroup Medicare Wellpoint | $716 |
| Blue Cross | Anthem Medicare Virginia | $716 |
| Managed Medicaire | Managed Medicaire | $716 |
| Sentara Health | Sentara Medicare | $716 |
| United Healthcare | United Healthcare Medicare | $716 |
| United Mine Workers Of America | United Mine Workers Of America | $716 |
| Humana | Humana Medicare | $728 |
| Aetna | Aetna Better Health Of Virginia Medicare | $738 |
| Molina Healthcare | Molina Healthcare Medicare | $745 |
| Cigna Healthcare | Cigna Medicare | $752 |
| Devoted Health Plan | Devoted Health Plan Medicare | $752 |
| Nhc Advantage | Nhc Advantage | $752 |
| Medcost | Medcost Vhn | $836 |
| Sentara Health | Sentara Health | $881 |
| Ambetter | Ambetter | $884 |
| Blue Cross | Anthem Exchange | $1,261 |
| Blue Cross | Anthem HMO | $1,378 |
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