CT abdomen and pelvis with contrast at Froedtert Hospital. CPT 74177.
What Froedtert Hospital publishes for this service, straight from its standard-charges file, last updated December 31, 2025.
Outpatient / ER
$2,838cash price (self-pay)
$5,160list price
$363–$5,802range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Community Care | Medicare Advantage | $363 |
| Health Partners | Medicare Advantage | $363 |
| Molina | Medicare Advantage | $363 |
| Priority Health | Medicare Advantage | $363 |
| Quartz | Medicare Advantage | $363 |
| Security Health Plan | Medicare Advantage | $363 |
| Network Health Plan | Medicare Advantage | $363 |
| Anthem Blue Cross Blue Shield | Medicare Advantage | $363 |
| Upper Peninsula Health Plan | Medicare Advantage | $363 |
| ICare | Medicare Advantage | $363 |
| United Healthcare | Medicare Advantage/Dual | $363 |
| Wellcare | Medicare Advantage | $370 |
| Aetna | Medicare Advantage | $370 |
| Care Wisconsin/MyChoice | Medicare Advantage | $374 |
| Network Health Plan | Marketplace Plans | $930 |
| Network Health Plan | All Contracted Commercial Payers | $1,033 |
| Sheboygan Employers Health Network | All Contracted Commercial Payers | $1,084 |
| United Healthcare | Nexus | $1,112 |
| United Healthcare/United Medical Resources | Choice Plus/Navigate | $1,351 |
| Anthem Blue Cross Blue Shield | Blue Preferred/POS | $1,466 |
| Centivo | WI 2 Median | $1,548 |
| United Healthcare/United Medical Resources | Options PPO | $1,621 |
| Centivo | WI 1 Broad | $1,703 |
| Medical College of Wisconsin | Employee Plan | $1,703 |
| Chorus Community Health Plan | All Contracted Commercial Plans | $2,012 |
| Health Partners | All Contracted Commercial Plans | $3,199 |
| Wisconsin Physician Services Statewide Alliance | All Contracted Comme | $3,251 |
| Trilogy | All Contracted Commercial Plans | $3,354 |
| Aetna | All Contracted Commercial Plans | $3,354 |
| Health Payment Systems | All Contracted Commercial Plans | $3,395 |
Inpatient
$2,838cash price (self-pay)
$5,160list price
$3,354–$5,802range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Trilogy | All Contracted Commercial Plans | $3,354 |
| Aetna | All Contracted Commercial Plans | $3,354 |
| Health Payment Systems | All Contracted Commercial Plans | $3,395 |
| Security Health Plan | All Contracted Commercial Plans | $4,057 |
| Dean Health Plan | All Contracted Commercial Plans | $4,128 |
| Group Health Cooperative | All Contracted Commercial Plans | $4,128 |
| HealthEos | All Contracted Commercial Plans | $4,128 |
| Multiplan/Private Healthcare Systems | All Contracted Commercial Plans | $4,128 |
| HealthSmart | All Contracted Commercial Plans | $4,283 |
| Wisconsin Physician Services | All Contracted Commercial Plans | $4,386 |
| First Health Network | All Contracted Commercial Plans | $4,463 |
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