CT abdomen and pelvis with contrast at Providence Saint John's Health Center. CPT 74177.
What Providence Saint John's Health Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$1,949cash price (self-pay)
$5,569list price
$449–$1,632range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Managed Care Plan | $449 |
| Humana | Choicecare Medicare Managed Care Plan | $458 |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $470 |
| Central Health Plan | Medicare Managed Care Plan | $494 |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $529 |
| La Care Health Plan | Covered Ca Exchange | $583 |
| Unitedhealthcare | All Commercial Plans | $611 |
| Unitedhealthcare | Select/Navigate Hmo | $611 |
| Aetna | All Commercial Plans | $633 |
| Healthnet | Ambetter Hmo | $830 |
| Healthnet | Ambetter Ppo | $960 |
| Blue Shield | Medicare Managed Care Plan | $1,207 |
| Blue Cross | All Commercial Plans | $1,323 |
| Blue Shield | Epn/Ifp Benefit Exchange | $1,431 |
| Blue Shield | Tandem Ppo/Blue High Performance Ppo/Epo | $1,468 |
| Blue Shield | Hmo | $1,632 |
| Blue Shield | Ppo/Epo | $1,632 |
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All common services at Providence Saint John's Health Center