CPT 74177
The standard charge for CT scan of abdomen & pelvis with contrast material is $369.00. However, the price you pay depends on the rate negotiated by your insurance plan and what portion your insurance plan requires you to contribute towards that amount. Enter your info below to start your estimate.
To calculate an estimate of your cost, you will need two things:
LOCATION
56-117 Pualalea Street, Kahuku, HI, 96731CONTACT
(808) 293-9221 Visit WebsiteIn compliance with the Centers for Medicare and Medicaid Services (CMS) Final 2020 Price Transparency Rules, effective January 1, 2021, all hospitals in the United States annually must provide a machine-readable file containing negotiated charges (rates) for ALL items and services. Additionally, the rule requires that for 300 shoppable items and services only, hospitals must provide a consumer-friendly display of gross charge and negotiated charges (rates) or estimation tool. Accordingly, below you will find links to the consumer estimation tool and the machine-readable file.
The fees and/or costs provided via this tool are only estimates, and your final bill may be higher or lower than the estimate for various reasons including but not limited to differences in the number of conditions among patients having the same or similar primary procedures, differences in physician ordering practices, unforeseen complications, etc. Moreover, this is not a guarantee of your benefit plan coverage or payment, and the actual payer and patient portion reflected in your final bill may also be higher or lower.
In some instances, where no recent historical claims and/or payment information is available for the payer plan and the item or service you have selected, the estimate may be for the base rate only or not available. Consequently, the estimate may exclude estimates for additional charges and payer payments for services billed in conjunction with the item or service you selected.
Also, this estimate DOES NOT include other services billed for separately by other providers including but not limited to physician or practitioner fees such as pathologist, radiologist, anesthesiologist, physician surgeon or assistant surgeon, etc.
If you have questions about your individual situation or were unable to find an estimate for your upcoming service, please contact us at (808)293-9221
Choose a plan to view the insurance rate estimate.
Total estimated charges
$369.00Insurance Discount
-$173.00Price Negotiated by Insurer
$196.00Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$92.00Comprehensive Metabolic Profile DLS
$79.50iohexol 350 mg/mL Soln [KMC]
$2.16Urinalysis w/ Reflex
$15.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Insurance Discount
-$204.36Price Negotiated by Insurer
$164.64Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$77.28Comprehensive Metabolic Profile DLS
$66.78iohexol 350 mg/mL Soln [KMC]
$2.03Urinalysis w/ Reflex
$12.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Insurance Discount
-$114.20Price Negotiated by Insurer
$254.80Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$119.60Comprehensive Metabolic Profile DLS
$103.35iohexol 350 mg/mL Soln [KMC]
$2.81Urinalysis w/ Reflex
$19.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Insurance Discount
-$8.36Price Negotiated by Insurer
$360.64Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$169.28Comprehensive Metabolic Profile DLS
$146.28iohexol 350 mg/mL Soln [KMC]
$4.44Urinalysis w/ Reflex
$27.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Insurance Discount
-$204.36Price Negotiated by Insurer
$164.64Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$77.28Comprehensive Metabolic Profile DLS
$66.78iohexol 350 mg/mL Soln [KMC]
$2.03Urinalysis w/ Reflex
$12.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Insurance Discount
-$188.38Price Negotiated by Insurer
$180.62Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$10.74Comprehensive Metabolic Profile DLS
$14.61iohexol 350 mg/mL Soln [KMC]
$0.15Urinalysis w/ Reflex
$4.37This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Price Negotiated by Insurer
$515.17Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$9.71Comprehensive Metabolic Profile DLS
$13.20Urinalysis w/ Reflex
$3.96This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Insurance Discount
-$204.36Price Negotiated by Insurer
$164.64Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$77.28Comprehensive Metabolic Profile DLS
$66.78iohexol 350 mg/mL Soln [KMC]
$2.03Urinalysis w/ Reflex
$12.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Price Negotiated by Insurer
$412.14Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$7.77Comprehensive Metabolic Profile DLS
$10.56iohexol 350 mg/mL Soln [KMC]
$4.59Urinalysis w/ Reflex
$3.17This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Insurance Discount
-$35.80Price Negotiated by Insurer
$333.20Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$156.40Comprehensive Metabolic Profile DLS
$135.15iohexol 350 mg/mL Soln [KMC]
$3.67Urinalysis w/ Reflex
$25.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Insurance Discount
-$204.36Price Negotiated by Insurer
$164.64Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$77.28Comprehensive Metabolic Profile DLS
$66.78iohexol 350 mg/mL Soln [KMC]
$1.81Urinalysis w/ Reflex
$12.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Insurance Discount
-$16.20Price Negotiated by Insurer
$352.80Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$165.60Comprehensive Metabolic Profile DLS
$143.10iohexol 350 mg/mL Soln [KMC]
$4.35Urinalysis w/ Reflex
$27.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Insurance Discount
-$169.08Price Negotiated by Insurer
$199.92Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$93.84Comprehensive Metabolic Profile DLS
$81.09iohexol 350 mg/mL Soln [KMC]
$2.46Urinalysis w/ Reflex
$15.30This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Insurance Discount
-$204.36Price Negotiated by Insurer
$164.64Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$77.28Comprehensive Metabolic Profile DLS
$66.78iohexol 350 mg/mL Soln [KMC]
$2.03Urinalysis w/ Reflex
$12.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Price Negotiated by Insurer
$380.24Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$178.48Comprehensive Metabolic Profile DLS
$154.23iohexol 350 mg/mL Soln [KMC]
$4.19Urinalysis w/ Reflex
$29.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Insurance Discount
-$204.36Price Negotiated by Insurer
$164.64Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$77.28Comprehensive Metabolic Profile DLS
$66.78iohexol 350 mg/mL Soln [KMC]
$1.81Urinalysis w/ Reflex
$12.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Insurance Discount
-$204.36Price Negotiated by Insurer
$164.64Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$77.28Comprehensive Metabolic Profile DLS
$66.78iohexol 350 mg/mL Soln [KMC]
$2.03Urinalysis w/ Reflex
$12.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Insurance Discount
-$188.38Price Negotiated by Insurer
$180.62Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$10.74Comprehensive Metabolic Profile DLS
$14.61iohexol 350 mg/mL Soln [KMC]
$0.30Urinalysis w/ Reflex
$4.37This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Insurance Discount
-$204.36Price Negotiated by Insurer
$164.64Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$77.28Comprehensive Metabolic Profile DLS
$66.78iohexol 350 mg/mL Soln [KMC]
$2.03Urinalysis w/ Reflex
$12.60This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.
Total estimated charges
$369.00Price Negotiated by Insurer
$727.57Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
CBC w/ Diff & Platelet Count DLS
$20.09Comprehensive Metabolic Profile DLS
$27.32iohexol 350 mg/mL Soln [KMC]
$3.52Urinalysis w/ Reflex
$8.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kahuku Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kahuku Medical Center directly.