CT abdomen and pelvis with contrast at Mercy Hospital of Folsom. CPT 74177.

What Mercy Hospital of Folsom publishes for this service, straight from its standard-charges file, last updated February 28, 2026.

Outpatient / ER

$3,644cash price (self-pay)

$9,367list price

$247–$7,681range insurers pay

Insurance plan	Negotiated rate
Hill Physicians \| Commercial\|All Plans	$247
United \| Medicaid\|< 21	$282
United \| Medicaid\|> 21	$282
Hill Physicians \| Medicaid\|All Plans	$310
Hill Physicians \| Medicare\|All Plans	$361
BCBS - Anthem \| Medicare\|All Other Plans	$443
Humana \| Commercial\|All Plans	$469
Aetna \| Medicare\|All Plans	$469
Blue Shield CA \| Medicare\|HMO	$469
Blue Shield CA \| Medicare\|PPO	$469
Kaiser \| Medicare\|All Plans	$469
United \| Medicare\|All Plans	$469
BCBS - Anthem \| Medicare\|Imperial	$483
Molina \| Medicaid\|All Plans	$530
BCBS - Anthem \| Medicaid\|All Plans	$535
California Health & Wellness \| Medicaid\|All Plans	$665
Health Net \| Medicaid\|All Plans	$665
Aetna \| Commercial\|All Other Plans	$795
Aetna \| Commercial\|HMO	$795
Aetna \| Commercial\|PPO	$795
United \| Commercial\|All Other Plans	$828
United \| Commercial\|HMO	$828
United \| Commercial\|Non-Options PPO	$828
WCMG \| Commercial\|All Plans	$1,030
Partnership Health Plan \| Medicaid\|All Plans	$1,212
BCBS - Anthem \| Commercial\|Connection EPO	$2,580
BCBS - Anthem \| Commercial\|All Other Plans	$3,225
Western Health Advantage \| Commercial\|All Plans	$3,278
Kaiser \| Medicaid\|All Plans	$3,840
Cigna \| Commercial\|LocalPlus	$3,925

$3,644cash price (self-pay)

$9,367list price

$1,030–$7,681range insurers pay

Insurance plan	Negotiated rate
WCMG \| Commercial\|All Plans	$1,030
First Health \| Commercial\|All Plans	$7,025
Healthsmart \| Commercial\|All Plans	$7,025
Sutter Health \| Commercial\|All Plans	$7,494
MultiPlan \| Commercial\|All Plans	$7,681

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