CT of Abdomen and Pelvis
NYC Health and Hospitals - Metropolitan
What goes into a price?
Prices across providers
Self pay or cash prices vary by provider when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts providers charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.
Procedures included in this package
This list includes the services and fees bundled into the CT of Abdomen and Pelvis Standard Service Package (SSP RA004). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.
| Code | Code Type | Description |
|---|---|---|
| HCPCS 74177 | Base Code | CT of abdomen and pelvis |
| HCPCS 74177 | Professional Fee | CT of abdomen and pelvis |
| RC 0352 | Facility Fee | CT Scan - Body scan |
| HCPCS Q9967 | Facility Fee | Non-ionic low osmolar contrast, 300-399mg/ml iodine concentration per ml |
| RC 0636 | Facility Fee | Pharmacy - Extension of 025X - Drugs requiring detailed coding |
| HCPCS 71260 | Facility Fee | CT thorax scan with contrast injection |
| HCPCS 80053 | Facility Fee | Comprehensive Metabolic Panel |