Providence Holy Family Hospital — CT scan prices
← Hospital overviewVerified from Providence Holy Family Hospital’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.
15 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| HC CT ABD & PELVIS WO CONTRAST Inpatient & outpatient | 74176 HCPCS | $5,374 | $3,762 | — | — | |
| HC CT ABD & PELVIS WO CONTRAST Outpatient | 74176 HCPCS | $846 | $592 | — | — | |
| HC CT ABDOMEN & PELVIS W CONTRAST Inpatient & outpatient | 74177 HCPCS | $7,183 | $5,028 | — | — | |
| HC CT ABDOMEN & PELVIS W CONTRAST Outpatient | 74177 HCPCS | $1,364 | $955 | — | — | |
| HC CT ABDOMEN & PELVIS W & W/O CONTRAST Inpatient & outpatient | 74178 HCPCS | $7,899 | $5,529 | — | — | |
| HC CT ABDOMEN & PELVIS W & W/O CONTRAST Outpatient | 74178 HCPCS | $1,500 | $1,050 | — | — | |
| HC CT HEAD/BRAIN W CONTRAST Inpatient & outpatient | 70460 HCPCS | $3,077 | $2,154 | — | — | |
| HC CT HEAD/BRAIN W CONTRAST Outpatient | 70460 HCPCS | $977 | $684 | — | — | |
| HC CT HEAD/BRAIN WO CONTRAST Inpatient & outpatient | 70450 HCPCS | $1,745 | $1,222 | — | — | |
| HC CT HEAD/BRAIN WO CONTRAST Outpatient | 70450 HCPCS | $496 | $347 | — | — | |
| HC CT THORAX W CONTRAST Inpatient & outpatient | 71260 HCPCS | $1,496 | $1,047 | — | — | |
| HC CT THORAX W CONTRAST Outpatient | 71260 HCPCS | $871 | $610 | — | — | |
| HC CT THORAX W/O DYE F/U LUNG SCREENING Inpatient & outpatient | 71250 HCPCS | $1,449 | $1,014 | — | — | |
| HC CT THORAX WO CONTRAST Inpatient & outpatient | 71250 HCPCS | $1,449 | $1,014 | — | — | |
| HC CT THORAX WO CONTRAST Outpatient | 71250 HCPCS | $443 | $310 | — | — |