Munson Healthcare Charlevoix Hospital — CT scan prices
← Hospital overviewVerified from Munson Healthcare Charlevoix Hospital’s published price file
Includes cash prices, list prices, insurance-negotiated rates. 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.
42 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| 3074 CT ABD + PEL W/O NO ORAL IV Inpatient | 74176 CPT | $2,335 | $1,985 | $1,868 – $2,335 | — | |
| 3076 CT ABD + PEL W/O IV ORAL ONLY Inpatient | 74176 CPT | $2,335 | $1,985 | $1,868 – $2,335 | — | |
| 3078 CT CHEST W/ CONTRAST Inpatient | 71260 CPT | $1,245 | $1,058 | $996 – $1,245 | — | |
| 3080 CT CHEST W CONTR Inpatient | 71260 CPT | $1,245 | $1,058 | $996 – $1,245 | — | |
| 93073 CT CHEST W/O NO ORAL+IV Inpatient | 71250 CPT | $1,043 | $887 | $834 – $1,043 | — | |
| 93075 CT CHEST W/O IV ORAL ONLY Inpatient | 71250 CPT | $1,043 | $887 | $834 – $1,043 | — | |
| 93077 CT ABD PELV W/ IV CONT Inpatient | 74177 CPT | $2,594 | $2,205 | $2,075 – $2,594 | — | |
| 93079 CT ABD PELV W/ IV+ORAL CONT Inpatient | 74177 CPT | $2,594 | $2,205 | $2,075 – $2,594 | — | |
| CT ABD + PELVIS W/+W/O CONTR (ORAL+IV) Inpatient | 74178 CPT | $2,796 | $2,377 | $2,237 – $2,796 | — | |
| CT ABD + PELVIS W/IV CONT (NO ORAL) Inpatient | 74177 CPT | $2,594 | $2,205 | $2,075 – $2,594 | — | |
| CT ABD + PELVIS W/O CONT (NO ORAL-NO IV) Inpatient | 74176 CPT | $2,335 | $1,985 | $1,868 – $2,335 | — | |
| CT ABD + PELVIS W/O IV CONT (ORAL ONLY) Inpatient | 74176 CPT | $2,335 | $1,985 | $1,868 – $2,335 | — | |
| CT ABD+PELV ORAL ONLY Inpatient | 74176 CPT | $2,335 | $1,985 | $1,868 – $2,335 | — | |
| CT ABD+PELV W/O NO O/IV Inpatient | 74176 CPT | $2,335 | $1,985 | $1,868 – $2,335 | — | |
| CT ABDOMEN + PELVIS W/CONTRAST (ORAL+IV) Inpatient | 74177 CPT | $2,594 | $2,205 | $2,075 – $2,594 | — | |
| CT CHEST + ABD W/O CONT (NO ORAL-NO IV) Inpatient | 71250 CPT | $1,043 | $887 | $834 – $1,043 | — | |
| CT CHEST + ABDOMEN W/ CONT (ORAL + IV) Inpatient | 71260 CPT | $1,245 | $1,058 | $996 – $1,245 | — | |
| CT CHEST + ABDOMEN W/O IV (ORAL ONLY) Inpatient | 71250 CPT | $1,043 | $887 | $834 – $1,043 | — | |
| CT CHEST ABD PELVIS W/IV CONT (NO ORAL) Inpatient | 74177 CPT | $2,594 | $2,205 | $2,075 – $2,594 | — | |
| CT CHEST ABD PELVIS W/O (NO ORAL-NO IV) Inpatient | 71250 CPT | $1,043 | $887 | $834 – $1,043 | — | |
| CT CHEST ABD PELVIS W/O IV (ORAL ONLY) Inpatient | 71250 CPT | $1,043 | $887 | $834 – $1,043 | — | |
| CT CHEST ABDOMEN PELVIS W/CONT (ORAL+IV) Inpatient | 74177 CPT | $2,594 | $2,205 | $2,075 – $2,594 | — | |
| CT CHEST W/ CONTRAST Inpatient | 71260 CPT | $1,245 | $1,058 | $996 – $1,245 | — | |
| CT CHEST W/CONTR-- Inpatient | 71260 CPT | $1,245 | $1,058 | $996 – $1,245 | — | |
| CT CHEST W/O CONTRAST Inpatient | 71250 CPT | $1,043 | $887 | $834 – $1,043 | — | |
| CT CHEST W/O CONTRAST ION PROTOCOL Inpatient | 71250 CPT | $1,043 | $887 | $834 – $1,043 | — | |
| CT ENTEROGRAPHY Inpatient | 74177 CPT | $2,594 | $2,205 | $2,075 – $2,594 | — | |
| CT ESOPHAGRAM CHEST/ABD W/O (ORAL ONLY) Inpatient | 71250 CPT | $1,043 | $887 | $834 – $1,043 | — | |
| CT Exams Inpatient | 70450 CPT | $1,024 | $870 | $819 – $1,024 | — | |
| CT Exams Inpatient | 70460 CPT | $1,235 | $1,050 | $988 – $1,235 | — |