Covenant Medical Center — CT scan prices
← Hospital overviewVerified from Covenant Medical Center’s published price file
Includes cash prices, list prices. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
16 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| HC CT ABD & PELVIS WO CONTRAST Outpatient | 74176 HCPCS | $2,309 | $310 | — | — | |
| HC CT ABD & PELVIS WO CONTRAST Inpatient & outpatient | 74176 HCPCS | $10,648 | $310 | — | — | |
| HC CT ABDOMEN & PELVIS W CONTRAST Outpatient | 74177 HCPCS | $3,694 | $460 | — | — | |
| HC CT ABDOMEN & PELVIS W CONTRAST Inpatient & outpatient | 74177 HCPCS | $14,197 | $460 | — | — | |
| HC CT ABDOMEN & PELVIS W & W/O CONTRAST Outpatient | 74178 HCPCS | $3,794 | $460 | — | — | |
| HC CT ABDOMEN & PELVIS W & W/O CONTRAST Inpatient & outpatient | 74178 HCPCS | $21,113 | $460 | — | — | |
| HC CT HEAD/BRAIN W CONTRAST Outpatient | 70460 HCPCS | $1,629 | $684 | — | — | |
| HC CT HEAD/BRAIN W CONTRAST Inpatient & outpatient | 70460 HCPCS | $7,687 | $3,229 | — | — | |
| HC CT HEAD/BRAIN WO CONTRAST Outpatient | 70450 HCPCS | $994 | $140 | — | — | |
| HC CT HEAD/BRAIN WO CONTRAST Inpatient & outpatient | 70450 HCPCS | $5,765 | $140 | — | — | |
| HC CT THORAX W CONTRAST Outpatient | 71260 HCPCS | $1,792 | $753 | — | — | |
| HC CT THORAX W CONTRAST Inpatient & outpatient | 71260 HCPCS | $8,984 | $3,773 | — | — | |
| HC CT THORAX W/O DYE F/U LUNG SCREENING Outpatient | 71250 HCPCS | $1,093 | $459 | — | — | |
| HC CT THORAX W/O DYE F/U LUNG SCREENING Inpatient & outpatient | 71250 HCPCS | $5,302 | $2,227 | — | — | |
| HC CT THORAX WO CONTRAST Outpatient | 71250 HCPCS | $1,093 | $459 | — | — | |
| HC CT THORAX WO CONTRAST Inpatient & outpatient | 71250 HCPCS | $5,302 | $2,227 | — | — |