CT abdomen and pelvis with contrast at MemorialCare Orange Coast Medical Center. CPT 74177.
What MemorialCare Orange Coast Medical Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$10,055cash price (self-pay)
$10,055list price
$404–$2,784range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Seoul Medical Group | Ipa Medicare Managed Care Plan | $404 |
| Blue Shield | Senior Medicare Managed Care Plan | $440 |
| Blue Cross | Senior Medicare Managed Care Plan | $449 |
| Unitedhealthcare | All Payer Other Commercial Plan | $458 |
| Unitedhealthcare | Non-Preferred Hmo | $458 |
| Unitedhealthcare | Preferred Hmo | $458 |
| Molina | Senior Medicare Managed Care Plan | $462 |
| Blue Cross | Anthem Vivity City Other Commercial Plan | $470 |
| Universal Care | Senior Medicare Managed Care Plan | $471 |
| Central Health | Senior Medicare Managed Care Plan | $494 |
| Blue Cross | Anthem Vivity Non-City Other Commercial Plan | $529 |
| Clever Care | Medicare Managed Care Plan | $538 |
| Healthcare Partners | Senior/Dual Eligible Medicare Managed Care Plan | $561 |
| Select Health | Hmo | $606 |
| Blue Cross | Anthem Hmo Exchange | $664 |
| Monarch Health Plan | Covered California Other Commercial Plan | $772 |
| Centivo | Ppo | $1,010 |
| Blue Cross | Anthem Non-Mcs Other Commercial Plan | $1,021 |
| Monarch Health Plan | Other Commercial Plan | $1,041 |
| Cigna | Select Hmo | $1,043 |
| Healthcare Partners | All Commercial Plans | $1,164 |
| Cigna | Value Hmo | $1,189 |
| Blue Cross | Anthem Mcs Other Commercial Plan | $1,225 |
| Cigna | All Commercial Plans | $1,541 |
| Blue Shield | Epn/Covered Ca Other Commercial Plan | $2,071 |
| Blue Shield | Trio Other Commercial Plan | $2,121 |
| Blue Shield | Tandem Ppo Other Commercial Plan | $2,310 |
| Blue Shield | Hmo/Pos | $2,424 |
| Blue Shield | Ppo/Epo | $2,784 |
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All common services at MemorialCare Orange Coast Medical Center