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
Winston-Salem, NC
See all hospitals reporting CPT 74176 →Price type
Forsyth Memorial Hospital, Inc.’s median price of $620 is 18% 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, 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 | 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 | $619.90 | $619.90 | $619.90 – $619.90 |
| 7 | UnitedHealthcare medicaid fee schedule · outpatient | $619.90 | $619.90 | $619.90 – $619.90 |
| 8 | WellCare medicaid fee schedule · outpatient | $619.90 | $619.90 | $619.90 – $619.90 |
| 9 | Cigna aca fee schedule · outpatient | $1,267 | $1,267 | $1,267 – $1,267 |
| 10 | Caresource qualified health plan fee schedule · outpatient | $1,309 | $1,309 | $1,309 – $1,309 |
| 11 | Blue Cross Blue Shield blue home fee schedule · outpatient | $1,709 | $1,709 | $1,709 – $1,709 |
| 12 | Blue Cross Blue Shield blue value fee schedule · outpatient | $1,767 | $1,767 | $1,767 – $1,767 |
| 13 | Cigna commercial fee schedule · outpatient | $1,944 | $1,944 | $1,944 – $1,944 |
| 14 | Aetna commercial fee schedule · outpatient | $2,016 | $2,016 | $2,016 – $2,016 |
| 15 | UnitedHealthcare all payer fee schedule · outpatient | $2,203 | $2,203 | $2,203 – $2,203 |
| 16 | Blue Cross Blue Shield hmo fee schedule · outpatient | $2,249 | $2,249 | $2,249 – $2,249 |
| 17 | Blue Cross Blue Shield ppo fee schedule · outpatient | $2,249 | $2,249 | $2,249 – $2,249 |
| 18 | Cigna commercial percent of total billed charges · outpatientfrom % of charges | $2,378 | $2,378 | $2,378 – $2,378 |
| 19 | Humana commercial fee schedule · outpatient | $2,550 | $2,550 | $2,550 – $2,550 |
| 20 | Aetna aca fee schedule · outpatient | $2,618 | $2,618 | $2,618 – $2,618 |
| 21 | Aetna first health fee schedule · outpatient | $2,618 | $2,618 | $2,618 – $2,618 |
| 22 | Aetna non-par products of apcn fee schedule · outpatient | $2,618 | $2,618 | $2,618 – $2,618 |
| 23 | Aetna rental network products fee schedule · outpatient | $2,618 | $2,618 | $2,618 – $2,618 |
| 24 | Aetna whole health non-multitier fee schedule · outpatient | $2,618 | $2,618 | $2,618 – $2,618 |
| 25 | Medcost mbs fee schedule · outpatient | $2,782 | $2,782 | $2,782 – $2,782 |
Last updated: Mar 30, 2026
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