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
CT ABD PELVIS WO CONTRAST
Clemmons, NC
See all hospitals reporting CPT 74176 →Price type
Forsyth Memorial Hospital, Inc.’s median price of $634 is 21% above the median hospital's median price ($524), higher than 56% 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: 11 payers, 28 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 | Blue Cross Blue Shield blue medicare fee schedule · outpatient | $231.41 | $231.41 | $231.41 – $231.41 |
| 2 | Humana medicare fee schedule · outpatient | $231.41 | $231.41 | $231.41 – $231.41 |
| 3 | UnitedHealthcare medicare fee schedule · outpatient | $231.41 | $231.41 | $231.41 – $231.41 |
| 4 | Aetna medicare fee schedule · outpatient | $237.20 | $237.20 | $237.20 – $237.20 |
| 5 | Cigna healthspring fee schedule · outpatient | $238.35 | $238.35 | $238.35 – $238.35 |
| 6 | Blue Cross Blue Shield healthy blue medicaid fee schedule · outpatient | $633.92 | $633.92 | $633.92 – $633.92 |
| 7 | UnitedHealthcare medicaid fee schedule · outpatient | $633.92 | $633.92 | $633.92 – $633.92 |
| 8 | WellCare medicaid fee schedule · outpatient | $633.92 | $633.92 | $633.92 – $633.92 |
| 9 | Cigna aca fee schedule · outpatient | $1,295 | $1,295 | $1,295 – $1,295 |
| 10 | Caresource qualified health plan fee schedule · outpatient | $1,339 | $1,339 | $1,339 – $1,339 |
| 11 | Blue Cross Blue Shield blue home fee schedule · outpatient | $1,747 | $1,747 | $1,747 – $1,747 |
| 12 | Blue Cross Blue Shield blue value fee schedule · outpatient | $1,807 | $1,807 | $1,807 – $1,807 |
| 13 | Cigna commercial fee schedule · outpatient | $1,988 | $1,988 | $1,988 – $1,988 |
| 14 | Aetna commercial fee schedule · outpatient | $2,062 | $2,062 | $2,062 – $2,062 |
| 15 | UnitedHealthcare all payer fee schedule · outpatient | $2,253 | $2,253 | $2,253 – $2,253 |
| 16 | Blue Cross Blue Shield hmo fee schedule · outpatient | $2,299 | $2,299 | $2,299 – $2,299 |
| 17 | Blue Cross Blue Shield ppo fee schedule · outpatient | $2,299 | $2,299 | $2,299 – $2,299 |
| 18 | Humana commercial fee schedule · outpatient | $2,607 | $2,607 | $2,607 – $2,607 |
| 19 | Aetna aca fee schedule · outpatient | $2,678 | $2,678 | $2,678 – $2,678 |
| 20 | Aetna first health fee schedule · outpatient | $2,678 | $2,678 | $2,678 – $2,678 |
| 21 | Aetna non-par products of apcn fee schedule · outpatient | $2,678 | $2,678 | $2,678 – $2,678 |
| 22 | Aetna rental network products fee schedule · outpatient | $2,678 | $2,678 | $2,678 – $2,678 |
| 23 | Aetna whole health non-multitier fee schedule · outpatient | $2,678 | $2,678 | $2,678 – $2,678 |
| 24 | Medcost mbs fee schedule · outpatient | $2,845 | $2,845 | $2,845 – $2,845 |
| 25 | Beechstreet commercial fee schedule · outpatient | $3,012 | $3,012 | $3,012 – $3,012 |
Last updated: Mar 30, 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.