# Ct Abdomen Pelvis: Cost, Coverage, and What to Expect Source: https://ourhealthnetwork.com/procedure-costs/ct-abdomen-pelvis Last reviewed: 2026-04-17 Data: CMS Hospital and Outpatient pricing, CPT/HCPCS code mapping ## Quick answer Medicare pays about $91 to the radiologist to read a CT of the abdomen and pelvis. Your full bill, including the facility fee, typically runs $300 to $1,500 on commercial insurance and $500 to $3,000 uninsured, depending on setting and whether contrast is used. ## What it is A CT scan of the abdomen and pelvis is a detailed X-ray that rotates around you to build cross-section images of everything from your lower ribs to your hip bones. That window covers the liver, kidneys, pancreas, spleen, bladder, intestines, reproductive organs, lymph nodes, and the major blood vessels in between. A radiologist reads the images afterward and sends a report to your doctor, usually within 24 hours. - **Scan time:** The actual imaging takes 10 to 30 seconds. You'll be on the table 15 to 45 minutes total including setup. - **Contrast:** Many scans require IV contrast (a clear dye injected into your arm) and sometimes oral contrast (a drink you take an hour before). Contrast makes blood vessels, tumors, and inflammation show up more clearly. - **Anesthesia:** None. You're awake the whole time. - **Hospital stay:** Outpatient. You walk in, get scanned, and walk out the same day. - **Prep:** You may need to fast for 4 hours if getting contrast. Stop metformin for 48 hours after IV contrast per your doctor's instructions. CT of the abdomen and pelvis is one of the most common imaging studies in US medicine. Medicare alone pays for over 6 million of these scans every year. There are four main variants Medicare tracks, separated by whether contrast is used and whether the scan focuses on blood vessels. The variant your doctor orders drives both the clinical information and the price. ## When it is done Doctors order abdominal and pelvic CT scans for a huge range of reasons, which is part of why volume is so high. The scan gives a fast, accurate look at soft tissue, organs, bones, and blood vessels all at once, which is why ERs rely on it heavily. Your doctor may recommend this scan when: 1. You have unexplained abdominal or pelvic pain, especially if appendicitis, diverticulitis, or a kidney stone is suspected. 2. You need cancer staging or follow-up to check for tumor growth or spread. 3. You have unexplained weight loss, blood in your urine or stool, or abnormal blood work. 4. You've had trauma to the abdomen (a car accident or fall) and internal bleeding needs to be ruled out. 5. You have a known aneurysm, blood clot, or vascular disease that needs imaging (this is when a CT angiogram is ordered). 6. A prior ultrasound or X-ray found something abnormal that needs more detail. Alternatives exist. Ultrasound is cheaper and has no radiation, but it sees less. MRI gives better soft-tissue detail with no radiation, but it costs more and takes longer. CT is usually the fastest way to get a clear answer, which is why it's the default in urgent situations. ## What you pay The Medicare figures above are only the professional fee: what the radiologist gets paid to read the images. The facility fee, which covers the scanner, the technologist, the contrast material, and the building, is billed separately and is usually the bigger chunk. Commercial insurers typically pay 2 to 4 times what Medicare pays for both parts, which is why the same scan can look cheap on a Medicare statement and expensive on a commercial explanation of benefits. **If you're on Medicare:** - Part B covers outpatient CT scans at 80% after you meet your annual deductible ($257 in 2025). - You pay 20% coinsurance on both the professional fee and the facility fee. - A Medigap supplemental plan usually covers that 20%, dropping your out-of-pocket to near zero. - Medicare Advantage plans typically charge a flat copay of $0 to $200 per scan, depending on your plan. **If you have commercial insurance:** - Expect a total allowed amount of $400 to $2,500 depending on setting and variant. - You'll pay your deductible first, then coinsurance (usually 10% to 30%) up to your out-of-pocket maximum. - If you haven't hit your deductible, you could owe the full contracted rate, often $800 to $2,000. - Ask whether your plan uses a radiology benefit manager that steers you to lower-cost freestanding centers for a smaller copay. **If you're uninsured or paying cash:** - Freestanding imaging centers often advertise bundled cash-pay prices of $300 to $700 for a CT abdomen/pelvis, including contrast and the radiologist read. - Hospital charge-master prices can run $3,000 to $8,000, but hospitals will almost always negotiate 30% to 70% off if you ask and pay upfront. - Hospital charity-care programs usually kick in if your income is under 200% to 400% of the federal poverty level. - Sites like Save On Medical, MDSave, and your local imaging center's cash-pay page are the fastest way to compare negotiated prices. ## Anatomy of the bill A single CT scan of the abdomen and pelvis almost never generates one bill. You'll typically see two or three separate charges, sometimes from different companies, even though you only walked into one building. **Facility fee (technical component):** This covers the scanner, the room, the CT technologist, and overhead. It's the largest line item and varies wildly by setting. A hospital outpatient department bills 2x to 5x what a freestanding imaging center bills for the exact same scan. Medicare pays $68 on average in facility settings (reflecting hospital outpatient) and $154 in office settings (reflecting freestanding centers) for the professional fee. The technical component that piggybacks on these can add hundreds to thousands more. **Professional interpretation fee (radiologist):** This is the charge for the radiologist reading the images and writing the report. It's what the Medicare figures in this page reflect. You'll often see this billed by a separate radiology group even when the scan happened at a hospital. **Contrast material:** IV contrast (iodinated dye) adds $50 to $200 to the bill. Oral contrast is cheaper. If you don't need contrast (variant 74176), you save this line item entirely. **Sedation:** Rarely needed for abdominal CT. If used (typically for claustrophobia or for children), add $100 to $500 depending on what medications and who administers them. **Pre-scan office visit or ER visit:** If the CT was ordered during a separate office or ER visit, that visit is billed on its own. An ER visit with a CT can easily total $3,000 to $8,000 once all pieces are added up. ## Cost by state State-level Medicare data shows the professional fee alone ranging from $64 in West Virginia to $130 in Maryland, a roughly 2x spread. Commercial prices swing even wider. Among the highest-volume states, Florida (4.1M scans), California (4.1M), and Texas (2.4M) lead the country by sheer volume, while Maryland, Arizona ($121), and New Jersey ($114) run well above the national average of $91. The takeaway: where you live, and specifically where in your metro area you go, matters a lot. Why costs vary by state: - **Medicare Geographic Practice Cost Index (GPCI):** Medicare adjusts payment by local cost of practice, so high-cost-of-living metros like DC, Manhattan, and coastal California get higher rates. - **Commercial negotiation leverage:** In consolidated hospital markets, a handful of health systems can demand premium commercial rates. In competitive markets with many freestanding imaging centers, prices fall. - **State price transparency laws:** A handful of states (Colorado, New Hampshire, Massachusetts) publish actual negotiated rates, making shopping easier. - **State surprise-billing protections:** Some states have stronger rules than the federal No Surprises Act, which affects what you end up owing when out-of-network providers sneak onto your bill. ## Office vs facility The single biggest lever on what you pay for this scan is whether you get it at a hospital outpatient department or a freestanding (office-based) imaging center. Medicare data shows facility settings (hospital outpatient) handle about 80% of the volume (5.0M scans) while office settings handle 20% (1.2M scans). But look at payment: Medicare pays radiologists $68 in facility settings and $154 in office settings, because in the facility setting the hospital separately bills a much larger technical/facility fee on top. Commercial and cash-pay patients feel this gap painfully. The same scan that runs $400 at a freestanding center can run $2,500 at a hospital outpatient department. Insurance steers patients toward lower-cost settings when it can. When each setting makes sense: - **Hospital outpatient:** Choose a hospital if your case is complex, you need same-day results for a serious concern, or your doctor wants the scan read alongside other hospital imaging. - **Freestanding imaging center:** Choose freestanding for routine follow-ups, non-urgent diagnostic workups, and anything where cost matters and a next-day report is fine. - **ER CT:** If you're in an ER with possible appendicitis or trauma, you get imaged where you are. Don't second-guess this. ## Who performs the procedure Diagnostic radiologists read essentially every CT scan done in the US. The data shows 21,603 diagnostic radiologists accounting for the overwhelming majority of abdominal CT reads, followed by 1,282 interventional radiologists, who read scans tied to procedures they perform. A CT technologist (a non-physician) actually runs the scanner and positions you, but they don't read the images. The radiologist who reads your scan is usually the one you never meet, and that's fine. What matters is that they're board-certified and reading enough volume to stay sharp. Hospital and large freestanding imaging centers almost always meet this bar. - **Accreditation:** Look for American College of Radiology (ACR) accreditation, which certifies equipment quality and radiologist credentials. - **Board certification:** All radiologists should be certified by the American Board of Radiology. - **Turnaround time:** Freestanding centers often promise reports in 24 hours. Ask. - **Subspecialty reads:** For complex cancer cases, ask whether a fellowship-trained abdominal radiologist will read the scan. - **Equipment generation:** Modern 64-slice or 128-slice scanners give better images at lower radiation doses. - **Prior image comparison:** Make sure the center can pull your prior imaging for comparison. This is one of the biggest drivers of accurate diagnosis. Small counts of internal medicine, urology, or oncology providers appear in the data (under 250 providers each); these reflect clinicians who occasionally bill CT-related codes for their patients, not primary readers of the images. ## How to shop for the best price Imaging is one of the most shoppable services in American medicine because the exact same scan (same CPT code, same quality) is available at wildly different prices in most cities. A 30-minute phone-call investment can save $500 to $2,000. 1. **Ask your doctor for a CPT code and whether contrast is required.** Without the code (74176, 74177, 74178, or 74174), you can't compare prices apples-to-apples. 2. **Call 3 freestanding imaging centers for cash-pay and insurance prices.** Ask specifically: "What's your all-in price for CPT [code] including contrast and the radiologist read?" 3. **Call your insurance company to verify in-network status** for the center, the radiology group that reads scans there, and whether pre-authorization is needed. 4. **Request a Good Faith Estimate.** Federal law (No Surprises Act, 2022) requires any provider to give uninsured or self-pay patients a written estimate before a scheduled scan. 5. **Check cash-pay marketplaces** like MDSave, Save On Medical, or your hospital's price-transparency page (also required by federal law). 6. **Ask the hospital for their uninsured discount or charity-care application** before you walk in. Discounts of 30% to 70% off charge-master prices are routine if you ask. 7. **Pay upfront for an extra discount.** Many centers offer 10% to 20% off if you pay at time of service. Red flags to watch for: - An imaging center that won't quote a cash price over the phone. - A hospital bill from a radiology group you've never heard of (this is normal, but verify that group is in-network). - A quoted price missing either the technical or the professional component. ## Surprise billing risks The most common surprise bills for abdominal CT come from the radiologist, not the facility. You pick an in-network hospital for the scan, but the radiology group that reads scans at that hospital is out-of-network, so you get a separate bill weeks later at a much higher rate. The federal No Surprises Act (2022) protects you from this in most cases at emergency rooms and for most in-network facility visits, but enforcement is not automatic. Most common surprise-billing sources for this scan: - **Out-of-network radiologist at an in-network facility** (No Surprises Act should protect you here; insist on it). - **Separate facility fee from a hospital-owned imaging center** that patients assumed was an independent clinic. - **Contrast material billed separately** from the scan itself, often by a third-party supplier. - **Pre-authorization denials** that turn a covered scan into a denied claim, leaving you with the full bill. - **ER visit bundles** where the CT is covered but the ER physician and the facility are billed separately. If you get a surprise bill: - **Don't pay it immediately.** Request an itemized bill showing every CPT code, the billed charge, the allowed amount, and the patient responsibility. - **Verify each provider's in-network status** at the time of service. If any were out-of-network at an in-network facility, the No Surprises Act likely applies. - **File a complaint at cms.gov/nosurprises** or call 1-800-985-3059. You can also contact your state insurance commissioner. - **Ask for a payment plan or financial assistance** if the bill is legitimate but unaffordable. Hospitals almost always offer 0% payment plans. ## Total recovery cost There's no real recovery from a CT scan. You walk out and resume normal activity the same day. If you had IV contrast, drink extra water for the next 24 hours to help your kidneys flush it out. If you had oral contrast, expect some GI upset for a day. The "total cost" for a CT scan is less about recovery and more about downstream care that often follows: Add-on costs to budget for: - **Follow-up office visit** to review results: $100 to $400 depending on setting and insurance. - **Additional imaging** if the CT finds something ambiguous (MRI, ultrasound, or repeat CT in 6 months): $400 to $3,000. - **Specialist consultation** (GI, urology, oncology): $200 to $600. - **Biopsy** if a mass is found and needs tissue diagnosis: $1,500 to $5,000. - **Prescription medications** if inflammation, infection, or kidney stones are found: $20 to $200 typically. - **Time off work:** Usually none for the scan itself, but follow-up visits and potential procedures can add up. - **Patient transportation and parking:** $10 to $50 per visit, which matters if you end up with multiple follow-ups. For most people, a single clean scan is the whole story and the total cost is just the scan itself. For patients whose CT reveals a finding that needs workup, the total episode can easily run 3x to 10x the cost of the scan alone. Budget for that possibility, especially if you're uninsured or high-deductible. ## Variants of this procedure - CT Angiogram of Abdomen & Pelvis - CT Abdomen & Pelvis Without Contrast - CT Abdomen & Pelvis With Contrast - CT Abdomen & Pelvis With and Without Contrast ## Frequently asked questions ### How much does a CT of the abdomen and pelvis cost with insurance? With commercial insurance, expect a total allowed amount of $400 to $2,500, of which you'll pay $100 to $700 after deductible and coinsurance. If you've already met your out-of-pocket maximum, you may pay nothing. Freestanding centers usually trigger smaller bills than hospital outpatient departments for the same scan. ### Does Medicare cover a CT of the abdomen and pelvis? Yes. Medicare Part B covers medically necessary CT scans of the abdomen and pelvis at 80% of the approved amount after the annual deductible ($257 in 2025). You're responsible for 20% coinsurance unless you have a Medigap plan. Medicare Advantage plans usually charge a flat copay instead. ### What's the cheapest way to get a CT of the abdomen and pelvis? Cash-pay or insurance, the answer is usually the same: a freestanding imaging center, not a hospital outpatient department. Bundled cash-pay prices of $300 to $700 are widely available. Call three centers and compare. Ask about upfront payment discounts and confirm the radiologist read is included. ### What's the difference between the four variants (74176, 74177, 74178, 74174)? 74176 is without contrast (cheapest), 74177 adds IV contrast (most common), 74178 does both pre- and post-contrast scans (pricier because it's essentially two scans), and 74174 is a CT angiogram focused on blood vessels (most specialized). Your doctor picks based on what clinical question needs answering. ### Why does the 74178 (before and after contrast) variant cost more than 74177 even though fewer people get it? Medicare prices procedures based on resource use (time, equipment, complexity), not volume. A 74178 scan takes longer, uses more radiologist time, and generates more images to read. So it pays more per scan even though 74177 is far more commonly ordered. ### How long does a CT scan take and will I need to stay at the hospital? The scan itself takes 10 to 30 seconds. You'll be in the room 15 to 45 minutes including setup and contrast injection. It's fully outpatient, so you go home the same day. Budget 1 to 2 hours total for check-in, scan, and contrast observation. ### How do I avoid a surprise bill for my CT scan? Before the scan, confirm the facility, the radiology group that reads scans there, and any separate contrast supplier are all in-network. Request a Good Faith Estimate in writing. After the scan, if you get a surprise bill from an out-of-network provider at an in-network facility, invoke the No Surprises Act at cms.gov/nosurprises. ### Where does this cost data come from? The Medicare figures on this page come from CMS Medicare Physician & Other Practitioners Public Use Files covering over 6 million CT abdomen and pelvis scans per year. Commercial and cash-pay ranges are based on published hospital price transparency data and freestanding imaging center cash-pay rates. ## Related - [All procedure cost concepts](https://ourhealthnetwork.com/procedure-costs) - [Find specialists who perform this procedure](https://ourhealthnetwork.com/find-doctors) - [Insurance plans that cover this procedure](https://ourhealthnetwork.com/tools/insurance-matcher)