CT abdomen and pelvis with contrast at UVA Health Prince William Medical Center. CPT 74177.
What UVA Health Prince William Medical Center publishes for this service, straight from its standard-charges file, last updated March 24, 2026.
Outpatient / ER
$1,680cash price (self-pay)
$3,360list price
$230–$3,024range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CHAMPVA [50002] | UVAMC & UVACHM & UVAPW & UVAHM - Tricare | $230 |
| TRICARE [50001] | UVAMC & UVACHM & UVAPW & UVAHM - Tricare | $230 |
| ANTHEM MEDICARE [10503] | UVAPW - Managed Medicare (various) | $361 |
| UNITED HEALTHCARE MEDICARE [10507] | UVAPW - Managed Medicare (various | $361 |
| VA CCN [99927] | UVAPW - Managed Medicare (various) | $361 |
| VETERANS ADMINISTRATION [99910] | UVAPW - Managed Medicare (various) | $361 |
| VIRGINIA PREMIER MEDICARE [10508] | UVAPW - Managed Medicare (various) | $361 |
| CIGNA HEALTHSPRING MEDICARE [10519] | UVAPW - Managed Medicare (variou | $361 |
| KAISER PERMANENTE MEDICARE [10513] | UVAPW - Managed Medicare (Kaiser) | $361 |
| LIFEWORKS MEDICARE [10515] | UVAPW - Managed Medicare (various) | $361 |
| MEDICARE REPLACEMENT GENERIC [10500] | UVAPW - Managed Medicare (vario | $361 |
| SENTARA MEDICARE [10506] | UVAPW - Managed Medicare (various) | $361 |
| VA CCN [99926] | UVAPW - Managed Medicare (various) | $361 |
| AETNA MEDICARE [10501] | UVAPW - Managed Medicare - Aetna | $365 |
| HUMANA MEDICARE [10505] | UVAPW - Managed Medicare (Humana) | $368 |
| HUMANA TRANSPLANT [40054] | UVAPW - Managed Medicare (Humana) | $368 |
| ANTHEM [30001] | UVAPW - Anthem Exchange | $781 |
| CIGNA [40005] | UVAPW & UVAHM - Cigna (OAP) | $1,111 |
| UNITED HEALTHCARE [40032] | UVAPW - Anthem (PPO PAR HMO) | $1,116 |
| ANTHEM [30001] | UVAPW - Anthem (PPO PAR HMO) | $1,116 |
| ANTHEM CAREFIRST [30008] | UVAPW - Anthem (PPO PAR HMO) | $1,116 |
| ANTHEM UHC [30009] | UVAPW - Anthem (PPO PAR HMO) | $1,116 |
| Cigna [40005] | Cigna 182223 PPO [4000520] | $1,256 |
| Cigna [40005] | Cigna Nalc Supplemental [4000510] | $1,256 |
| Cigna [40005] | Cigna 188061 Connect [4000513] | $1,340 |
| CIGNA [40005] | UVAPW & UVAHM - Cigna (IFP) | $1,340 |
| United Healthcare [40032] | United Exchange Plan [4003231] | $1,496 |
| GEHA [40009] | UVAPW & UVAHM - United (All Payer) | $1,660 |
| UNITED HEALTHCARE [40032] | UVAPW & UVAHM - United (All Payer) | $1,660 |
| AETNA [40002] | UVAPW & UVAHM - Aetna | $2,015 |
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All common services at UVA Health Prince William Medical Center