CT abdomen and pelvis with contrast at Children's Hospital of Orange County. CPT 74177.
What Children's Hospital of Orange County publishes for this service, straight from its standard-charges file, last updated March 19, 2026.
Outpatient / ER
$4,362cash price (self-pay)
$7,180list price
$200–$8,551range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross of California Medi-Cal/CalOptima/Healthy Families | Blue Cr | $282 |
| Health Net CalOPTIMA/Medi-Cal | Health Net CalOPTIMA/Medi-Cal | $282 |
| CALOPTIMA KIDS | CalOPTIMA Kids/CalOPTIMA Healthy Families | $352 |
| CALOPTIMA Direct | CalOPTIMA Direct | $395 |
| Alpha Care Medical Group | Alpha Care IPA MediCal | $409 |
| Blue Shield-TriWest-TriCare Programs | Blue Shield-TriWest-TriCare Pro | $449 |
| Blue Cross of California | Blue Cross/VIVITY/PIH-Presbyterian Health/H | $525 |
| Blue Cross of California HMO/POS/PPO | Blue Cross of California HMO/PO | $695 |
| Blue Cross of California | Blue Cross of California Select PPO Out Net | $895 |
| Blue Cross of California | Blue Cross of California HMO/POS In Net | $943 |
| Blue Cross of California | Blue Cross of California PPO/POS Out Net | $943 |
| Bristol Park Medical Group HMO/POS In Net | Bristol Park Medical Group | $1,000 |
| Affiliated Doctors of Orange County (ADOC) HMO/POS In Net | Affiliated | $1,200 |
| Arta Health Network | Arta Health Network HMO/POS In Net | $1,200 |
| Greater Newport Physicians | Greater Newport Physicians HMO/POS In Net | $1,500 |
| OptumHealth Care Solutions, Inc | OptumHealth Care Solutions HMO In Ne | $1,593 |
| OptumHealth Care Solutions, Inc | OptumHealth Care Solutions PPO Out N | $1,593 |
| Rady Childrens Hospital San Diego | Rady Childrens Hospital San Diego | $1,601 |
| Aetna US Healthcare | Aetna US Healthcare HMO/POS In Net | $2,617 |
| Aetna US Healthcare | Aetna US Healthcare PPO/POS Out Net | $2,617 |
| Alpha Care Medical Group | Alpha Care IPA-HMO | $3,000 |
| Cigna Healthcare of California | Cigna EPO/PPO | $3,808 |
| Cigna Healthcare of California | Cigna Healthcare of California HMO/PO | $3,808 |
| Blue Shield of California UC Care PPO | Blue Shield of California UC C | $4,251 |
| Bright Medical Group | Bright Medical Group HMO/POS in Net | $4,308 |
| EPIC Management | EPIC Management In Network HMO | $4,308 |
| Family Choice (Fountain Valley Reg Hosp) | Family Choice (Fountain Val | $4,308 |
| Coventry Healthcare | Coventry Healthcare | $4,667 |
| Genesis Healthcare (Edward Medical Group) HMO/POS In Net | Genesis Hea | $4,667 |
| Blue Shield Exchange/Covered CA/PPO | Blue Shield Exchange/Covered CA/ | $4,983 |
Inpatient
$4,362cash price (self-pay)
$7,180list price
$1,963–$8,551range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Office of Refugee Resettlement-Point Comfort | Point Comfort Underwrit | $3,231 |
| UCI Medical Group | UCI Medical Group HMO/POS in Net | $4,667 |
| Affiliated Health Funds PPO | Affiliated Health Funds PPO** | $5,744 |
| MultiPlan PPO fka BCE Emergis PPO | MultiPlan PPO** | $5,744 |
| PPO Next PPO | PPO Next PPO** | $5,744 |
| Private Healthcare Systems (PHCS) EPO/PPO | Private Healthcare Systems | $6,462 |
| Charity | Charity** | $7,180 |
| Other Payer | Other Payer** | $7,180 |
| Self Pay | Self Pay** | $7,180 |
| US Behavioral Health Plan | United Behavioral Health Optum HMO In Net | $7,180 |
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