CT abdomen and pelvis with contrast at Mercy Medical Center Mt. Shasta. CPT 74177.

What Mercy Medical Center Mt. Shasta publishes for this service, straight from its standard-charges file, last updated February 28, 2026.

Outpatient / ER

$4,505cash price (self-pay)

$5,790list price

$383–$5,674range insurers pay

Insurance plan	Negotiated rate
BCBS - Anthem \| Medicaid\|All Plans	$383
California Health & Wellness \| Medicaid\|All Plans	$626
Partnership Health Plan \| Medicaid\|All Plans	$1,212
Aetna \| Medicare\|All Plans	$1,390
BCBS - Anthem \| Medicare\|All Plans	$1,390
Blue Shield CA \| Medicare\|All Plans	$1,390
Health Net \| Medicare\|All Plans	$1,390
Humana \| Medicare\|All Plans	$1,390
Kaiser \| Medicare\|All Plans	$1,390
United \| Medicare\|All Plans	$1,390
BCBS - Anthem \| Commercial\|Exchange	$3,937
Cigna \| Commercial\|All Other Plans	$4,748
Cigna \| Commercial\|PPO	$4,748
BCBS - Anthem \| Commercial\|All Other Plans	$4,864
United \| Commercial\|HMO	$4,979
Aetna \| Commercial\|All Other Plans	$5,037
Aetna \| Commercial\|HMO	$5,037
Aetna \| Commercial\|PPO	$5,037
United \| Commercial\|All Other Plans	$5,095
Health Net \| Commercial\|All Plans	$5,385
Coventry \| Commercial\|All Plans	$5,674
MultiPlan \| Commercial\|All Plans	$5,674

$4,505cash price (self-pay)

$5,790list price

$3,011–$5,674range insurers pay

Insurance plan	Negotiated rate
California Health & Wellness \| Medicaid\|All Plans	$3,011
Cigna \| Commercial\|All Other Plans	$4,748
Cigna \| Commercial\|PPO	$4,748
United \| Commercial\|HMO	$4,979
Aetna \| Commercial\|All Other Plans	$5,095
Aetna \| Commercial\|HMO	$5,095
Aetna \| Commercial\|PPO	$5,095
United \| Commercial\|All Other Plans	$5,095
Health Net \| Commercial\|All Plans	$5,385
Coventry \| Commercial\|All Plans	$5,674
MultiPlan \| Commercial\|All Plans	$5,674

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