CT abdomen and pelvis with contrast at University of Vermont Medical Center. CPT 74177.
What University of Vermont Medical Center publishes for this service, straight from its standard-charges file, last updated April 28, 2026.
Outpatient / ER
$390cash price (self-pay)
$1,454list price
$57.05–$6,451range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| MVP | Essential Plans | $160 |
| MVP | Managed Medicaid | $160 |
| United Healthcare | Managed Medicaid/Essential Plans | $199 |
| Excellus BlueCross BlueShield | Managed Medicaid/Essential Plans | $261 |
| Aetna | Medicare Advantage | $294 |
| Capital District Physicians' Health Plan | Managed Medicaid/Essential | $294 |
| Capital District Physicians' Health Plan | Medicare Advantage | $294 |
| Humana Military | TRICARE | $294 |
| Martins Point | TRICARE Prime/Department of Defense | $294 |
| St. Regis | HMO | $294 |
| United Healthcare | Medicare Advantage | $294 |
| Veterans Affairs Community Care Network | Veterans Administration | $294 |
| BlueCross BlueShield Vermont | Medicare Advantage | $300 |
| MVP | Medicare Advantage | $300 |
| Excellus BlueCross BlueShield | Medicare Advantage | $332 |
| Fidelis Care | Essential Plans | $338 |
| Fidelis Care | Managed Medicaid | $338 |
| Fidelis Care | Medicare Advantage | $338 |
| United Healthcare Empire Plan | Commercial PPO for NY State Employees | $375 |
| Wellpath | FCI Ray Brook | $411 |
| Capital District Physicians' Health Plan | Commercial | $582 |
| Wellpath | Correctional Healthcare | $800 |
| Excellus BlueCross BlueShield | Commercial | $856 |
| Empire BlueCross BlueShield | HMO | $1,102 |
| EBPA | ERISA Welfare Plans | $1,120 |
| Harvard Pilgrim | Commercial | $1,163 |
| MagnaCare | Commercial | $1,163 |
| Coventry | Commercial | $1,236 |
| NPPN | Commercial | $1,309 |
| BlueCross BlueShield Vermont | Indemnity | $1,354 |
Inpatient
$6,553cash price (self-pay)
$6,553list price
$1,835–$5,898range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana Military | TRICARE | $1,835 |
| Excellus BlueCross BlueShield | Managed Medicaid/Essential Plans | $3,145 |
| Capital District Physicians' Health Plan | Managed Medicaid/Essential | $3,277 |
| Wellpath | Correctional Healthcare | $3,604 |
| Excellus BlueCross BlueShield | Commercial | $4,898 |
| Empire BlueCross BlueShield | HMO | $5,111 |
| Harvard Pilgrim | Commercial | $5,242 |
| MagnaCare | Commercial | $5,242 |
| Coventry | Commercial | $5,570 |
| EBPA | ERISA Welfare Plans | $5,636 |
| Cigna | Behavioral Health | $5,898 |
| NPPN | Commercial | $5,898 |
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