CT abdomen and pelvis with contrast at Stoughton Hospital. CPT 74177.
What Stoughton Hospital publishes for this service, straight from its standard-charges file, last updated June 11, 2026.
Outpatient / ER
$3,428cash price (self-pay)
$6,233list price
$392–$24,932range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz Medicaid | Quartz Medicaid | $392 |
| Quartz Health Solutions - All Other Lans | Quartz Health Solutions - A | $780 |
| Tricare-All Plans | Tricare-All Plans | $1,483 |
| Dean Health Insurance Comm - All Other Plans | Dean Health Insurance C | $1,653 |
| Dean Health Insurance EPO | Dean Health Insurance EPO | $1,653 |
| Healthnet Mcr Adv - All Plans | Healthnet Mcr Adv - All Plans | $1,658 |
| Quartz Mcr Adv | Quartz Mcr Adv | $1,745 |
| Dean Health Insurance Med Adv | Dean Health Insurance Med Adv | $1,745 |
| Humana Med Adv | Humana Med Adv | $1,745 |
| Security Health/First Health - All Plans | Security Health/First Healt | $1,745 |
| Aetna Mcare | Aetna Mcare | $1,870 |
| UHC Mcr Adv | UHC Mcr Adv | $2,743 |
| Geha - All Plans | Geha - All Plans | $4,675 |
| Cigna - All Plans | Cigna - All Plans | $4,986 |
| UHC Comm - All Other Plans | UHC Comm - All Other Plans | $4,986 |
| Wisconsin PPO Ppa Direct - All Plans | Wisconsin PPO Ppa Direct - All | $4,986 |
| Aetna-All Other Plans | Aetna-All Other Plans | $5,298 |
| Anthem Blue Cross - All Plans | Anthem Blue Cross - All Plans | $5,423 |
| Humana - All Other Plans | Humana - All Other Plans | $5,610 |
| Wps - All Plans | Wps - All Plans | $5,610 |
| Alliance - All Plans | Alliance - All Plans | $24,932 |
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