Providence Holy Cross Medical Center — CT scan prices
← Hospital overviewVerified from Providence Holy Cross 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 Inpatient & outpatient | 74176 HCPCS | $6,395 | $2,238 | — | — | |
| HC CT ABD & PELVIS WO CONTRAST Outpatient | 74176 HCPCS | $2,196 | $769 | — | — | |
| HC CT ABDOMEN & PELVIS W CONTRAST Inpatient & outpatient | 74177 HCPCS | $7,840 | $2,744 | — | — | |
| HC CT ABDOMEN & PELVIS W CONTRAST Outpatient | 74177 HCPCS | $2,925 | $1,024 | — | — | |
| HC CT ABDOMEN & PELVIS W & W/O CONTRAST Inpatient & outpatient | 74178 HCPCS | $12,436 | $4,353 | — | — | |
| HC CT ABDOMEN & PELVIS W & W/O CONTRAST Outpatient | 74178 HCPCS | $3,828 | $1,340 | — | — | |
| HC CT HEAD/BRAIN W CONTRAST Inpatient & outpatient | 70460 HCPCS | $7,622 | $2,668 | — | — | |
| HC CT HEAD/BRAIN W CONTRAST Outpatient | 70460 HCPCS | $1,782 | $624 | — | — | |
| HC CT HEAD/BRAIN WO CONTRAST Inpatient & outpatient | 70450 HCPCS | $6,079 | $2,128 | — | — | |
| HC CT HEAD/BRAIN WO CONTRAST Outpatient | 70450 HCPCS | $1,379 | $483 | — | — | |
| HC CT THORAX W CONTRAST Inpatient & outpatient | 71260 HCPCS | $4,486 | $1,570 | — | — | |
| HC CT THORAX W CONTRAST Outpatient | 71260 HCPCS | $1,442 | $505 | — | — | |
| HC CT THORAX W/O DYE F/U LUNG SCREENING Inpatient & outpatient | 71250 HCPCS | $4,058 | $1,420 | — | — | |
| HC CT THORAX W/O DYE F/U LUNG SCREENING Outpatient | 71250 HCPCS | $1,162 | $407 | — | — | |
| HC CT THORAX WO CONTRAST Inpatient & outpatient | 71250 HCPCS | $4,058 | $1,420 | — | — | |
| HC CT THORAX WO CONTRAST Outpatient | 71250 HCPCS | $1,162 | $407 | — | — |