CT abdomen and pelvis with contrast at Banner Page Hospital. CPT 74177.
What Banner Page Hospital publishes for this service, straight from its standard-charges file, last updated September 22, 2026.
Outpatient / ER
$115cash price (self-pay)
$4,932list price
$117–$4,685range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Arizona Physicians IPA | Medicaid | $242 |
| Banner University Health Plan | AZ Medicaid - AHCCCS | $242 |
| Health Choice Arizona, Inc. | Medicaid | $242 |
| Health Net | Medicaid | $242 |
| Mercy Care | Mercy Medicaid | $242 |
| Aetna | Banner Employee Plans | $358 |
| Plotkin Health | Plotkin Health | $1,168 |
| Banner Health | Medicare Advantage | $1,376 |
| Aetna | Medicare Advantage | $1,376 |
| Arizona Physicians IPA | Medicare Advantage | $1,376 |
| Banner University Health Plan | Medicare Advantage | $1,376 |
| Blue Cross Blue Shield of Arizona | Medicare Advantage | $1,376 |
| Cigna Healthcare of Arizona, Inc. | HMO Medicare Advantage Plan/PPO Me | $1,376 |
| Gila River Health Care Corporation | Managed Care Program | $1,376 |
| Health Choice Arizona, Inc. | Medicare Advantage | $1,376 |
| Health Net | Medicare | $1,376 |
| Kaiser Foundation Health Plan | Medicare Advantage | $1,376 |
| Mercy Care | Mercy Care Advantage | $1,376 |
| Carekin | Medicare Advantage | $1,444 |
| Humana | Medicare Advantage | $1,458 |
| Arizona Priority Care | Medicare Advantage | $1,513 |
| Devoted Health Services | Medicare Advantage | $1,513 |
| Gold Kidney Health Plan | Medicare Advantage | $1,513 |
| Blue Cross Blue Shield of Arizona | BXBSAZ Neighborhood | $1,602 |
| Blue Cross Blue Shield of Arizona | BXBSAZ Alliance/BXBSAZ Blue HPN | $1,709 |
| Blue Cross Blue Shield of Arizona | BXBSAZ Alliance CHS | $1,794 |
| Aetna | Joint Venture | $1,884 |
| Coconino County Sheriff's Department | Commercial | $1,895 |
| Health Choice Arizona, Inc. | ACA Health Plan | $2,063 |
| Health Net | Commerical Exchange Product | $2,077 |
Inpatient
$115cash price (self-pay)
$2,596list price
$117–$4,685range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Plotkin Health | Plotkin Health | $1,168 |
| Quiktrip Corporation | Commercial | $1,817 |
| Coconino County Sheriff's Department | Commercial | $1,895 |
| Aetna | Medical Rental | $2,313 |
| Provider Network of America | Commercial | $2,336 |
| Cigna Healthcare of Arizona, Inc. | Commerical/HMO Benefit Plan/Local | $2,390 |
| Arizona Medical Network | Commercial | $2,437 |
| National Healthcare Solutions Inc (NHSI) and VIP Universal Medical Ins | $2,466 |
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