CT abdomen and pelvis with contrast at Sentara Northern Virginia Medical Center. CPT 74177.
What Sentara Northern Virginia Medical Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$3,334cash price (self-pay)
$6,668list price
$347–$3,753range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Managed Care Plan | $347 |
| Humana | Medicare Managed Care Plan | $351 |
| Bcbs | Anthem Medicare Managed Care Plan | $357 |
| Unitedhealthcare | Dsnp Medicare Managed Care Plan | $357 |
| Bcbs | Anthem Exchange | $700 |
| Bcbs | Anthem Hmo | $753 |
| Bcbs | Anthem Ppo | $804 |
| Carefirst | Hmo | $3,411 |
| Carefirst | Ppo | $3,753 |
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All common services at Sentara Northern Virginia Medical Center