CT abdomen and pelvis with contrast at UVA Health Culpeper Medical Center. CPT 74177.
What UVA Health Culpeper Medical Center publishes for this service, straight from its standard-charges file, last updated March 24, 2026.
Outpatient / ER
$2,340cash price (self-pay)
$4,679list price
$235–$4,211range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CHAMPVA [50002] | UVAMC & UVACHM & UVAPW & UVAHM - Tricare | $235 |
| TRICARE [50001] | UVAMC & UVACHM & UVAPW & UVAHM - Tricare | $235 |
| AETNA MEDICARE [10501] | UVACMH - Managed Medicare (various) | $361 |
| HUMANA MEDICARE [10505] | UVACMH - Managed Medicare (various) | $361 |
| KAISER PERMANENTE MEDICARE [10513] | UVACMH - Managed Medicare (variou | $361 |
| MOLINA COMPLETE CARE MEDICARE [10517] | UVACMH - Managed Medicare (var | $361 |
| SENTARA MEDICARE [10506] | UVACMH - Managed Medicare (various) | $361 |
| VA CCN [99926] | UVACMH - Managed Medicare (various) | $361 |
| VA CCN [99927] | UVACMH - Managed Medicare (various) | $361 |
| ANTHEM MEDICARE [10503] | UVACMH - Managed Medicare (various) | $361 |
| CIGNA HEALTHSPRING MEDICARE [10519] | UVACMH - Managed Medicare (vario | $361 |
| LIFEWORKS MEDICARE [10515] | UVACMH - Managed Medicare (various) | $361 |
| MEDICARE REPLACEMENT GENERIC [10500] | UVACMH - Managed Medicare (vari | $361 |
| UNITED HEALTHCARE MEDICARE [10507] | UVACMH - Managed Medicare (variou | $361 |
| VETERANS ADMINISTRATION [99910] | UVACMH - Managed Medicare (various) | $361 |
| VIRGINIA PREMIER MEDICARE [10508] | UVACMH - Managed Medicare (various | $361 |
| ANTHEM [30001] | UVACMH - Anthem Exchange | $805 |
| ANTHEM CAREFIRST [30008] | UVACMH - Anthem (PPO PAR HMO) | $1,151 |
| UNITED HEALTHCARE [40032] | UVACMH - Anthem (PPO PAR HMO) | $1,151 |
| ANTHEM [30001] | UVACMH - Anthem (PPO PAR HMO) | $1,151 |
| ANTHEM UHC [30009] | UVACMH - Anthem (PPO PAR HMO) | $1,151 |
| Cigna [40005] | Cigna 188061 Connect [4000513] | $3,346 |
| CIGNA [40005] | UVACMH - Cigna (OAP) | $3,346 |
| GEHA [40009] | UVACMH - United (All Payer) | $3,509 |
| United Healthcare [40032] | United Exchange Plan [4003231] | $3,509 |
| Cigna [40005] | Cigna 182223 PPO [4000520] | $3,781 |
| Cigna [40005] | Cigna Nalc Supplemental [4000510] | $3,781 |
| SENTARA [40021] | UVACMH - Optima | $3,921 |
| AETNA [40002] | UVACMH - Aetna | $3,977 |
| MULTIPLAN GENERIC [40035] | UVACMH - Misc. (MultiPlan) | $4,089 |
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