CT abdomen and pelvis with contrast at CHOC at Mission Hospital. CPT 74177.
What CHOC at Mission Hospital publishes for this service, straight from its standard-charges file, last updated March 18, 2026.
Outpatient / ER
$8,992cash price (self-pay)
$8,992list price
$282–$8,992range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Heritage Provider Network | Heritage Provider Network-Medi-Cal | $282 |
| Medi-Cal Out of County | Medi-Cal Out of County Medi-Cal | $282 |
| Molina Medical Centers - Medi-Cal | Molina Medical Centers - Medi-Cal | $282 |
| Monarch Health Plan | Monarch Health Plan/Medi-Cal/Cal Optima | $282 |
| Medi-Cal Out of County-LA Care | LA Care Medi-Cal Out of County | $366 |
| CALOPTIMA Direct | CalOPTIMA Direct | $395 |
| Medi-Cal Kaiser | Medi-Cal Kaiser | $423 |
| Blue Shield-TriWest-TriCare Programs | Blue Shield-TriWest-TriCare Pro | $449 |
| Health Net Federal Services | Health Net Federal Services-Tricare Prog | $449 |
| Blue Cross of California | Blue Cross of California VIVITY HMO In Net | $536 |
| Inland Empire Health Plan | IEHP Medi-Cal Out of County-Inland Empire | $696 |
| Blue Cross of California | Blue Cross of California Select PPO Out Net | $860 |
| Blue Cross of California | Blue Cross of California HMO/POS In Net | $905 |
| Blue Cross of California | Blue Cross of California PPO/POS Out Net | $905 |
| MemorialCare MG (formerly Bristol Park MG) HMO/POS In Net | MemorialCa | $1,000 |
| Arta Health Network | Arta Health Network HMO/POS In Net | $1,200 |
| Hoag Clinic aka Hoag Affilated Physicians | Hoag Clinic aka Hoag Medic | $1,533 |
| Aetna US Healthcare | Aetna US Healthcare HMO/POS In Net | $3,687 |
| Aetna US Healthcare | Aetna US Healthcare PPO/POS Out Net | $3,687 |
| Heritage Provider Network | Heritage Provider Network-HMO | $4,000 |
| Monarch Health Plan | Monarch Health Plan | $5,170 |
| Cigna Healthcare of California | Cigna EPO/PPO | $5,368 |
| CIGNA HealthCare of California | Cigna Healthcare HMO/POS In Net | $5,368 |
| Anaheim Memorial Medical Center | Anaheim Memorial Medical Center | $5,395 |
| Family Choice Health Network (Fountain Valley Regional Hospital) | Fam | $5,395 |
| Kaiser Foundation Hospitals | Kaiser Foundation Hospitals HMO | $5,395 |
| Affiliated Doctors of Orange County | Affiliated Doctors of Orange Cou | $5,845 |
| Bright Medical Group | Bright Medical Group HMO/POS In Net | $5,845 |
| Greater Newport Physicians | Greater Newport Physicians HMO/POS In Net | $5,845 |
| Health Net | Health Net HMO/POS In Net | $6,007 |
Inpatient
$8,992cash price (self-pay)
$8,992list price
$4,046–$8,992range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Office of Refugee Resettlement-Point Comfort | Point Comfort Underwrit | $4,046 |
| Anaheim Memorial Medical Center | Anaheim Memorial Medical Center | $5,395 |
| Affiliated Health Funds | Affiliated Health Funds PPO | $7,194 |
| PPO Next | PPO Next PPO | $7,194 |
| MultiPlan | MultiPlan PPO | $8,093 |
| Other Payor | Other Payor | $8,992 |
| Self Pay | Self Pay | $8,992 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.