CT abdomen and pelvis with contrast at Stonewall Jackson Hospital. CPT 74177.
What Stonewall Jackson Hospital publishes for this service, straight from its standard-charges file, last updated May 19, 2026.
Outpatient / ER
$1,059cash price (self-pay)
$2,118list price
$210–$2,076range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health_plan_medicaid | Medicaid | $210 |
| Unicare_medicaid | Medicaid | $210 |
| Caresource_medicaid | Medicaid | $215 |
| Highmark_bcbs_medicaid | Medicaid | $221 |
| Aetna_better_health | Medicare | $280 |
| Humana | Medicare | $343 |
| Umwa | Medicare | $343 |
| Ves | Medicare | $343 |
| Universal_health | Medicare | $354 |
| Highmark_bcbs_ppo | Medicare | $1,527 |
| Highmark_bcbs_traditional | Medicare | $1,527 |
| Highmark_bcbs_aca | Medicare | $1,623 |
| Aetna | Commercial | $1,694 |
| Aetna_auto | Commercial | $1,694 |
| Aetna_medical_rental | Commercial | $1,694 |
| Aetna_work_comp | Commercial | $1,694 |
| Onenet | Commercial | $1,828 |
| Healthsmart_accel | Commercial | $1,906 |
| Healthsmart_auto | Commercial | $1,906 |
| Healthsmart_hpo | Commercial | $1,906 |
| Healthsmart_ppo | Commercial | $1,906 |
| Sharpe | Commercial | $1,906 |
| Cigna | Commercial | $1,910 |
| UHC | Commercial | $1,970 |
| Alliance_ppo | Commercial | $2,012 |
| Ccn | Commercial | $2,012 |
| Multiplan | Commercial | $2,012 |
| Napp | Commercial | $2,065 |
| 4_most | Commercial | $2,076 |
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