CT abdomen and pelvis with contrast at Banner Lassen Medical Center. CPT 74177.
What Banner Lassen Medical Center publishes for this service, straight from its standard-charges file, last updated September 12, 2026.
Outpatient / ER
$2,980cash price (self-pay)
$5,237list price
$71.29–$5,080range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Blue Cross California | Medicare Advantage | $71.29 |
| Partnership HealthPlan of CA | Partnership Medi-Cal | $465 |
| Banner Health | Banner Choice Plus/Banner Select | $2,147 |
| United Healthcare | UHC Medicare Advantage | $2,147 |
| TriWest Healthcare Alliance Corp - VA CCN | Tricare | $2,776 |
| Network Providers, LLC | California Prison Health Care Services (CPHCS | $2,791 |
| Imperial Health Plan of California, Inc | Medi-Medi/Medicare Advantage | $2,899 |
| Blue Shield of California | CalPERS PPO | $4,556 |
| Multiplan | Commercial | $4,713 |
| United Healthcare | Commercial | $4,870 |
| Cigna Healthcare & Life Insurance Company – WY | Commercial | $4,975 |
| Coventry | Commercial | $5,028 |
| Coventry | Workers Comp | $5,028 |
| First Health | Medical Rental | $5,028 |
| Health Net | Commercial Exchange | $5,080 |
| Health Net | Medicare | $5,080 |
Inpatient
$2,980cash price (self-pay)
$5,237list price
$4,556–$5,080range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Shield of California | CalPERS PPO | $4,556 |
| Multiplan | Commercial | $4,713 |
| United Healthcare | Commercial | $4,870 |
| Cigna Healthcare & Life Insurance Company – WY | Commercial | $4,975 |
| Coventry | Commercial | $5,028 |
| Coventry | Workers Comp | $5,028 |
| First Health | Medical Rental | $5,028 |
| Health Net | Commercial Exchange | $5,080 |
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