CT abdomen and pelvis with contrast at Tricities Hospital. CPT 74177.
What Tricities Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$16,308cash price (self-pay)
$16,308list price
$233–$14,677range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | HIX | $629 |
| Anthem | HPN | $798 |
| UNITED | AllPayerAppendix | $828 |
| UNITED | NavigateCorePayer | $828 |
| UNITED | NewBusiness | $828 |
| UNITED | SmallBusiness | $828 |
| Anthem | HMO | $865 |
| Anthem | PPO | $865 |
| Aetna | SharedSavings | $1,464 |
| Aetna | Broad | $1,773 |
| Lifeworks | MCR | $3,099 |
| United | OptionsPPO | $3,392 |
| Universal Healthcare Group | MCR | $3,588 |
| Virginia Health Network | ULTRA | $5,708 |
| United | GlobalBenefitPlan | $7,339 |
| Value Options | COMM | $9,785 |
| Virginia Health Network | COMM | $10,600 |
| Virginia Health Network | WC | $10,600 |
| CorVel | WorkersComp | $11,742 |
| OccuNet Workers Comp | WorkersComp | $13,046 |
| 4Most Health Nework | COMM | $14,677 |
| Multiplan | PHCS | $14,677 |
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