CT abdomen and pelvis with contrast at Modoc Medical Center. CPT 74177.
What Modoc Medical Center publishes for this service, straight from its standard-charges file, last updated September 28, 2026.
Outpatient / ER
$3,846cash price (self-pay)
$3,903list price
$339–$3,763range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Multiplan Wc | Multiplan Wc | $339 |
| Ntwrks By Design Wc - All Plans | Ntwrks By Design Wc - All Plans | $353 |
| Integrated Hp Wc | Integrated Hp Wc | $356 |
| Adv Med Mgmt - All Plans | Adv Med Mgmt - All Plans | $404 |
| Medi-Cal | Medi-Cal | $404 |
| Medi-Cal 7/1/24 | Medi-Cal 7/1/24 | $404 |
| Partnership Hp - All Plans | Partnership Hp - All Plans | $1,415 |
| Blue Shield Comm - All Other Plans | Blue Shield Comm - All Other Plan | $1,800 |
| Blue Shield Mcr Adv | Blue Shield Mcr Adv | $2,114 |
| Blue Shield Va | Blue Shield Va | $2,114 |
| Tricare UHC - All Plans | Tricare UHC - All Plans | $2,114 |
| Tricare Hlthnet - All Plans | Tricare Hlthnet - All Plans | $2,225 |
| Healthnet Mcr Adv | Healthnet Mcr Adv | $2,247 |
| Blue Shield Exch | Blue Shield Exch | $3,209 |
| Anthem Bc Exch | Anthem Bc Exch | $3,209 |
| Anthem Bc Comm - All Other Plans | Anthem Bc Comm - All Other Plans | $3,566 |
| Carelon - All Plans | Carelon - All Plans | $3,566 |
| Corvel - All Plans | Corvel - All Plans | $3,669 |
| Aetna - All Plans | Aetna - All Plans | $3,708 |
| Coventry/First Health - All Plans | Coventry/First Health - All Plans | $3,708 |
| Galaxy Health - All Plans | Galaxy Health - All Plans | $3,708 |
| Hmn - All Plans | Hmn - All Plans | $3,708 |
| Interplan - All Plans | Interplan - All Plans | $3,708 |
| Multiplan - All Other Plans | Multiplan - All Other Plans | $3,708 |
| Healthnet Comm - All Other Plans | Healthnet Comm - All Other Plans | $3,708 |
| Integrated Hp - All Other Plans | Integrated Hp - All Other Plans | $3,708 |
| Superior CA PPO - All Plans | Superior CA PPO - All Plans | $3,708 |
| UHC Comm - All Plans | UHC Comm - All Plans | $3,708 |
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