CT abdomen and pelvis with contrast at South Lincoln Hospital District. CPT 74177.
What South Lincoln Hospital District publishes for this service, straight from its standard-charges file, last updated July 8, 2026.
Outpatient / ER
$675cash price (self-pay)
$4,122list price
$82.88–$3,915range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Medicare Advantage | Aetna Medicare Advantage | $1,113 |
| Humana Mcr - All Plans | Humana Mcr - All Plans | $1,113 |
| BCBS Mcr Adv | BCBS Mcr Adv | $1,113 |
| BCBS Comm - All Other Plans | BCBS Comm - All Other Plans | $1,879 |
| UHC - All Plans | UHC - All Plans | $1,904 |
| Health Infonet/First Choice - All Plans | Health Infonet/First Choice | $2,385 |
| Altius Health Plans - All Plans | Altius Health Plans - All Plans | $3,709 |
| Cigna - All Plans | Cigna - All Plans | $3,709 |
| Great West Healthcare - All Plans | Great West Healthcare - All Plans | $3,709 |
| Integrated Hp - All Plans | Integrated Hp - All Plans | $3,709 |
| Winhealth Partners - All Plans | Winhealth Partners - All Plans | $3,709 |
| Ccn - All Plans | Ccn - All Plans | $3,915 |
| Geha - All Plans | Geha - All Plans | $3,915 |
| Three Rivers - All Plans | Three Rivers - All Plans | $3,915 |
| Aetna - All Other Plans | Aetna - All Other Plans | $3,915 |
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