CT abdomen and pelvis with contrast at UVA Health Medical Center. CPT 74177.
What UVA Health Medical Center publishes for this service, straight from its standard-charges file, last updated March 24, 2026.
Outpatient / ER
$3,785cash price (self-pay)
$6,308list price
$235–$5,526range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CHAMPVA [50002] | UVAMC & UVACHM & UVAPW & UVAHM - Tricare | $235 |
| BLUE RIDGE PACE [10510] | UVAMC - Managed Medicare (Innovage) | $315 |
| BLUE RIDGE PACE MEDICAID [20513] | UVAMC - Managed Medicare (Innovage) | $315 |
| AETNA IOE MEDICARE [10511] | UVAMC - Managed Medicare (various) | $350 |
| AETNA MEDICARE [10501] | UVAMC - Managed Medicare (various) | $350 |
| ANTHEM MEDICARE [10503] | UVAMC - Managed Medicare (various) | $350 |
| KAISER PERMANENTE MEDICARE [10513] | UVAMC - Managed Medicare (various | $350 |
| MEDICARE REPLACEMENT GENERIC [10500] | UVAMC - Managed Medicare (vario | $350 |
| MOLINA COMPLETE CARE MEDICARE [10517] | UVAMC - Managed Medicare (vari | $350 |
| OPTUM MEDICARE [10512] | UVAMC - Managed Medicare (various) | $350 |
| UHC OPTUM MEDICARE [10521] | UVAMC - Managed Medicare (various) | $350 |
| Va Ccn [99926] | Uvamc - Vaccn | $350 |
| Va Ccn [99927] | Uvamc - Vaccn | $350 |
| CIGNA HEALTHSPRING MEDICARE [10519] | UVAMC - Managed Medicare (variou | $350 |
| AETNA [40002] | UVAMC - Aetna (Comm. Book of Business) | $573 |
| ANTHEM [30001] | UVAMC - Anthem Exchange | $789 |
| AETNA [40002] | UVAMC - Aetna UVA Preferred | $966 |
| CIGNA [40005] | UVAMC - Cigna (New Business) | $1,000 |
| ANTHEM CAREFIRST [30008] | UVAMC - Anthem (PPO PAR HMO) | $1,045 |
| ANTHEM UHC [30009] | UVAMC - Anthem (PPO PAR HMO) | $1,045 |
| UNITED HEALTHCARE [40032] | UVAMC - Anthem (PPO PAR HMO) | $1,045 |
| ANTHEM [30001] | UVAMC - Anthem (PPO PAR HMO) | $1,045 |
| AETNA [40002] | UVAMC - Aetna (IFP) | $1,057 |
| CIGNA [40005] | UVAMC - Cigna (OAP) | $1,111 |
| AETNA MERITAIN SMALL BUSINESS [40061] | UVAMC - Aetna Small Business | $1,147 |
| AETNA [40002] | UVAMC - Aetna Small Business | $1,147 |
| CIGNA [40005] | UVAMC - Cigna (PPO) | $1,256 |
| BEACON HEALTH OPTIONS [40012] | UVAMC - Misc. (Beacon BH) | $3,154 |
| COMMERCIAL GENERIC [40000] | UVAMC - Valley Health | $3,312 |
| COMMERCIAL CONTRACTED HB ONLY [40056] | UVAMC - Valley Health | $3,312 |
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