CT abdomen and pelvis with contrast at Westfields Hospital. CPT 74177.
What Westfields Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$2,050cash price (self-pay)
$3,897list price
$328–$3,897range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Healthpartners [900713] | Hp Self Insured [91021] | $328 |
| BCBS Medicaid Replacement [950295] | BCBS Pmap [95296] | $608 |
| Hp Medicaid Replacement [950307] | Hp Care Pmap [50327] | $645 |
| Ucare Medicaid Replacement [950289] | Ucare Pmap [50283] | $1,548 |
| Hp Medicare Replacement [950306] | Hp Medicare Advantage [95307] | $1,598 |
| BCBS Medicare Replacement [950296] | BCBS Medicare Advantage [50299] | $1,621 |
| UHC Medicare Replacement [950281] | UHC Medicare Advantage PPO [50275] | $1,652 |
| Medica Medicare Replacement [950299] | Medica Government Advantage [50 | $1,668 |
| Medica [900156] | Medica Choice [90156] | $3,176 |
| First Health Network [950334] | First Health Network [95334] | $3,196 |
| Unitedhealthcare [900444] | UHC [50131] | $3,455 |
| MA Wisconsin Replacement [950271] | Ghc Of Eau Claire MA HMO [50261] | $3,897 |
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