CT abdomen and pelvis with contrast at Henry Mayo Newhall Memorial Hospital. CPT 74177.
What Henry Mayo Newhall Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 6, 2026.
Outpatient / ER
$8,757cash price (self-pay)
$8,757list price
$101–$3,687range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | HMO PPO | $101 |
| Aetna | Medicare Advantage | $447 |
| Anthem | Medicare Advantage | $447 |
| Blue Shield | Medicare Advantage | $447 |
| Facey | Medicare Advantage | $447 |
| Health Net | Medicare Advantage | $447 |
| Heritage Provider Network | Medicare Advantage | $447 |
| Humana | Medicare Advantage | $447 |
| Kaiser | Medicare Advantage | $447 |
| Optum Healthcare | Commercial | $447 |
| Providence Health | Medicare Advantage | $447 |
| United Healthcare | Medicare Advantage | $447 |
| Optum Healthcare | Medicare Advantage | $455 |
| Facey | Commercial HMO | $625 |
| Heritage Provider Network | Commercial | $670 |
| Health Net | Enhanced PPO | $804 |
| Aetna | HMO PPO | $883 |
| Blue Shield | Exchange | $1,842 |
| United Healthcare | Select & Select Plus | $3,429 |
| United Healthcare | Non Select | $3,687 |
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