CT abdomen and pelvis with contrast at Lewisgale Medical Center. CPT 74177.
What Lewisgale Medical Center publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$17,025cash price (self-pay)
$17,025list price
$384–$15,323range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United | AllPayerAppendix | $828 |
| Anthem | HIX | $1,038 |
| Anthem | HMO | $1,152 |
| Anthem | PPO | $1,152 |
| Aetna | SharedSavings | $2,919 |
| Cigna | NPR | $2,962 |
| Lifeworks | MCR | $3,235 |
| Universal Healthcare Group | MCR | $3,746 |
| Aetna | Broad | $4,530 |
| Virginia Health Network | ULTRA | $5,959 |
| United | OptionsPPO | $6,214 |
| United | GlobalBenefitPlan | $7,661 |
| Naphcare | Federal | $8,513 |
| Greenvbrier Sporting Club | COMM | $10,215 |
| Graham-White Manufacturing | COMM | $11,918 |
| Richfield Nursing Center | COMM | $11,918 |
| Virginia Health Network | COMM | $12,088 |
| Virginia Health Network | WC | $12,088 |
| CorVel | WorkersComp | $12,258 |
| Community Care Network | COMM | $12,769 |
| Richfield Retirement Community | COMM | $12,769 |
| CSX Hotels | Product | $13,620 |
| OccuNet Workers Comp | WorkersComp | $13,620 |
| One Health Plan | POS | $13,620 |
| One Health Plan | PPO | $13,620 |
| Patients Choice | COMM | $14,982 |
| 4Most | COMM | $15,323 |
| Alleghany Highland Community | COMM | $15,323 |
| American Postal Workers Union | COMM | $15,323 |
| C&O Employees Hospital Assn | COMM | $15,323 |
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