CT abdomen and pelvis with contrast at Los Robles Hospital And Medical Center. CPT 74177.
What Los Robles Hospital And Medical Center publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$6,651cash price (self-pay)
$12,603list price
$223–$13,611range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Brand New Day | MCD | $223 |
| Gold Coast Health Plan | MCD | $223 |
| Physician Health Network | MGMCD | $223 |
| United | AllPayerAppendix | $828 |
| Anthem | ExchangeEPO | $1,134 |
| Anthem | ExchangeHMO | $1,134 |
| Anthem | COMM | $1,197 |
| Aetna | EPO | $1,263 |
| Aetna | PPO | $1,311 |
| Aetna | HMO | $1,311 |
| MedCare Partners | MGMCR | $1,890 |
| United | OptionsPPO | $3,541 |
| Blue Shield | EPN | $3,759 |
| Blue Shield | COMM | $5,371 |
| United | GlobalBenefitPlan | $5,671 |
| First Health | COMM | $8,570 |
| First Health | WCOMP | $10,082 |
| Multiplan | PRIMARY | $10,082 |
| PPO Next | PPO | $10,082 |
| PPO Next | WC | $10,082 |
| Interplan Corporation | COMM | $11,342 |
| Interplan Corporation | WC | $11,342 |
| Ventura County Foundation | COMM | $11,342 |
| Multiplan | COMPLEMENTARY | $11,973 |
| Aetna Senior Health Plan | MCR | $12,603 |
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All common services at Los Robles Hospital And Medical Center