CT abdomen and pelvis with contrast at Northwest Medical Center. CPT 74177.
What Northwest Medical Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$3,403cash price (self-pay)
$14,266list price
$239–$12,915range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| APIPA Medicaid AZ | APIPA Medicaid AZ | $239 |
| Medicaid | AZ Medicaid | $239 |
| Complete Health Medicaid AZ | Complete Health Medicaid AZ | $239 |
| Health Choice Medicaid AZ | Health Choice Medicaid AZ | $239 |
| Mercy Care Medicaid AZ | Mercy Care Medicaid AZ | $239 |
| NON PAR Medicaid AZ | NON PAR Medicaid AZ | $239 |
| Magellan | Magellan Medicaid AZ | $251 |
| Banner UFC Medicaid AZ | Banner UFC Medicaid AZ | $256 |
| Aetna QHP | Aetna QHP | $276 |
| Aetna Performance | Aetna Performance | $309 |
| Aetna | Aetna ALL | $325 |
| Veterans Eval Services | Veterans Eval Services | $348 |
| NODE Aetna MCR ADV | NODE Aetna MCR ADV | $366 |
| NODE APIPA UHC Community Plan MCR ADV | NODE APIPA UHC Community Plan | $366 |
| NODE CareMore MCR ADV | NODE CareMore MCR ADV | $366 |
| Department of Veterans Affairs | NODE ChampVA | $372 |
| NODE Tricare | NODE Tricare | $372 |
| Bcbsaz Mcr Adv | Node BCBS Az Mcr Adv | $372 |
| NODE Banner MCR ADV | NODE Banner MCR ADV | $385 |
| NODE AZ Complete Health Ambetter Exchange | NODE AZ Complete Health Am | $525 |
| Health Net | Health Net Commercial | $590 |
| UHC Health Exchange | UHC HIX | $663 |
| United Healthcare | UHC Navigate | $700 |
| United Healthcare | UHC APA | $829 |
| BCBS PimaConnect | BCBS PimaConnect | $929 |
| BCBS Az PPO HMO Nbr | BCBS Az PPO HMO Nbr | $978 |
| Cigna LocalFlex | Cigna LocalFlex | $1,013 |
| Cigna | Cigna LocalPlus | $1,013 |
| Cigna | Cigna HMO | $1,055 |
| BCBS AZ | BCBS AZ Work Comp | $1,323 |
Inpatient
$5,105cash price (self-pay)
$14,266list price
$2,127–$12,915range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CHS Group Health Plan BCBST | CHS Group Health Plan BCBST | $2,140 |
| Aetna | Aetna ASBAIT | $2,568 |
| Self Pay | Self Pay | $5,136 |
| Aetna | Aetna IHS | $6,419 |
| First Health Coventry | First Health Coventry | $7,489 |
| Coventry Medical Center | Coventry Work Comp AZ | $8,559 |
| Multiplan | Multiplan Complementary | $11,840 |
| Prime Health | Prime Health | $12,126 |
| HealthSmart | HealthSmart HPO | $12,839 |
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