CT abdomen and pelvis with contrast at Central Vermont Medical Center. CPT 74177.
What Central Vermont Medical Center publishes for this service, straight from its standard-charges file, last updated April 28, 2026.
Outpatient / ER
$262cash price (self-pay)
$262list price
$80.11–$5,090range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BlueCross BlueShield Vermont | Indemnity/The Vermont Health Plan/Vermo | $92.17 |
| United Healthcare Empire Plan | Commercial PPO for NY State Employees | $167 |
| Humana Military | TRICARE | $210 |
| Aetna | Medicare Advantage | $218 |
| Martins Point | TRICARE Prime/Department of Defense | $218 |
| United Healthcare | Medicare Advantage | $218 |
| Veterans Affairs Community Care Network | Veterans Administration | $218 |
| BlueCross BlueShield Vermont | Medicare Advantage | $222 |
| MVP | Medicare Advantage | $223 |
| MVP | Commercial | $234 |
| Wellpath | Correctional Healthcare | $1,483 |
| Capital District Physicians' Health Plan | Commercial | $2,119 |
| Harvard Pilgrim | Commercial | $2,157 |
| Coventry | Commercial | $2,273 |
| Cigna | Commercial | $2,530 |
| United Healthcare | Commercial | $2,644 |
| BlueCross BlueShield Vermont | Indemnity | $4,713 |
| BlueCross BlueShield Vermont | The Vermont Health Plan/Vermont Health | $4,852 |
Inpatient
$5,131cash price (self-pay)
$5,131list price
$2,088–$5,100range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana Military | TRICARE | $2,088 |
| Wellpath | Correctional Healthcare | $2,822 |
| Martins Point | TRICARE Prime/Department of Defense | $3,284 |
| Capital District Physicians' Health Plan | Commercial | $4,104 |
| Harvard Pilgrim | Commercial | $4,104 |
| Coventry | Commercial | $4,464 |
| MVP | Commercial | $4,606 |
| United Healthcare | Commercial | $5,100 |
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