Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HC CT ABD&PELVIS W/O CONTRAS
Grapevine, TX
See all hospitals reporting CPT 74176 →Price type
Baylor Scott & White Medical Center - Grapevine’s median price of $1.5k is 177% above the median hospital's median price ($524), higher than 76% of the 2,634 hospitals reporting CPT 74176. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 29 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Superior Healthplan medicaid facility · fee schedule · outpatient | $188.11 | $188.11 | $188.11 – $188.11 |
| 2 | Aetna medicaid facility · fee schedule · outpatient | $191.87 | $191.87 | $191.87 – $191.87 |
| 3 | UnitedHealthcare medicaid/chip facility · fee schedule · outpatient | $201.28 | $201.28 | $201.28 – $201.28 |
| 4 | Baylor Scott White Health Plan medicare advantage facility · fee schedule · outpatient | $228.08 | $228.08 | $228.08 – $228.08 |
| 5 | Aetna medicare advantage facility · fee schedule · outpatient | $240.08 | $240.08 | $240.08 – $240.08 |
| 6 | Humana medicare facility · fee schedule · outpatient | $240.08 | $240.08 | $240.08 – $240.08 |
| 7 | Blue Cross Blue Shield medicare advantage facility · fee schedule · outpatient | $252.08 | $252.08 | $252.08 – $252.08 |
| 8 | Superior Healthplan medicare facility · fee schedule · outpatient | $252.08 | $252.08 | $252.08 – $252.08 |
| 9 | UnitedHealthcare medicare advantage facility · fee schedule · outpatient | $268.89 | $268.89 | $268.89 – $268.89 |
| 10 | Baylor Scott White Health Plan bsw premier - small group facility · fee schedule · outpatient | $288.10 | $288.10 | $288.10 – $288.10 |
| 11 | Baylor Scott White Health Plan bsw premier - individual facility · fee schedule · outpatient | $301.30 | $301.30 | $301.30 – $301.30 |
| 12 | Baylor Scott White Health Plan bsw plus - small group facility · fee schedule · outpatient | $396.13 | $396.13 | $396.13 – $396.13 |
| 13 | Ambetter ambetter exchange facility · fee schedule · outpatient | $516.17 | $516.17 | $516.17 – $516.17 |
| 14 | Blue Cross Blue Shield blue advantage facility · fee schedule · outpatient | $762.04 | $762.04 | $762.04 – $762.04 |
| 15 | Blue Cross Blue Shield blue premier/high performance network/my bluehealth facility · fee schedule · outpatient | $1,081 | $1,081 | $1,081 – $1,081 |
| 16 | Blue Cross Blue Shield city of dallas facility · fee schedule · outpatient | $1,452 | $1,452 | $1,452 – $1,452 |
| 17 | Blue Cross Blue Shield blue essentials (hmo) facility · fee schedule · outpatient | $1,531 | $1,531 | $1,531 – $1,531 |
| 18 | Baylor Scott White Health Plan bsw premier - large group/bsw premier direct to employer (rate 1)/bswh employee facility · fee schedule · outpatient | $1,557 | $1,557 | $1,557 – $1,557 |
| 19 | Blue Cross Blue Shield bluechoice (ppo) facility · fee schedule · outpatient | $1,613 | $1,613 | $1,613 – $1,613 |
| 20 | Cigna local plus facility · fee schedule · outpatient | $1,673 | $1,673 | $1,673 – $1,673 |
| 21 | Baylor Scott White Health Plan bsw plus - large group/bsw premier direct to employer (rate 2) facility · fee schedule · outpatient | $1,832 | $1,832 | $1,832 – $1,832 |
| 22 | UnitedHealthcare charter facility · fee schedule · outpatient | $1,959 | $1,959 | $1,959 – $1,959 |
| 23 | UnitedHealthcare nexus facility · fee schedule · outpatient | $1,959 | $1,959 | $1,959 – $1,959 |
| 24 | Cigna hmo/ppo facility · fee schedule · outpatient | $1,968 | $1,968 | $1,968 – $1,968 |
| 25 | UnitedHealthcare commercial broad facility · fee schedule · outpatient | $2,177 | $2,177 | $2,177 – $2,177 |
Last updated: Jun 29, 2026
See CT scan of abdomen and pelvis without contrast pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.