CT abdomen and pelvis with contrast at Providence Little Co of Mary Med Center San Pedro. CPT 74177.
What Providence Little Co of Mary Med Center San Pedro publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$2,703cash price (self-pay)
$7,724list price
$449–$1,207range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Managed Care Plan | $449 |
| Humana | Medicare Managed Care Plan | $458 |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $470 |
| Caremore | Medicare Managed Care Plan | $494 |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $529 |
| Aetna | All Commercial Plans | $581 |
| La Care Health Plan | Covered Ca Exchange | $583 |
| Unitedhealthcare | All Commercial Plans | $611 |
| Unitedhealthcare | Select/Navigate Hmo | $611 |
| Blue Shield | Epn/Ifp Benefit Exchange | $624 |
| Blue Shield | Tandem Ppo/Blue High Performance Ppo/Epo | $676 |
| Blue Shield | Hmo | $754 |
| Blue Shield | Ppo/Epo | $754 |
| Healthnet | Ambetter Hmo | $830 |
| Healthnet | Ambetter Ppo | $960 |
| Blue Cross | All Commercial Plans | $1,061 |
| Blue Shield | Medicare Managed Care Plan | $1,207 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.
All common services at Providence Little Co of Mary Med Center San Pedro