CT abdomen and pelvis with contrast at Rideout Memorial Hospital. CPT 74177.
What Rideout Memorial Hospital publishes for this service, straight from its standard-charges file, last updated July 6, 2026.
Outpatient / ER
$2,205cash price (self-pay)
$13,625list price
$85.21–$28,423range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Bc Mcal | Bc Mcal | $85.21 |
| Kaiser Mcal | Kaiser Mcal | $404 |
| Medi-Cal | Medi-Cal | $404 |
| Kaiser Mcr Adv | Kaiser Mcr Adv | $450 |
| Tricare Blue Shield-All Plans | Tricare Blue Shield-All Plans | $450 |
| UHC Mcr Adv | UHC Mcr Adv | $450 |
| Blue Cross Mcr Adv | Blue Cross Mcr Adv | $455 |
| CA Health And Wellness- All Plans | CA Health And Wellness- All Plans | $501 |
| Celtic Mcaid-All Plans | Celtic Mcaid-All Plans | $501 |
| Ah Employee Health Plan - All Plans | Ah Employee Health Plan - All Pl | $810 |
| Healthnet Mcal | Healthnet Mcal | $1,474 |
| Blue Cross-All Other Plans | Blue Cross-All Other Plans | $1,657 |
| Healthnet Comm-All Other Plans | Healthnet Comm-All Other Plans | $8,761 |
| Aetna-All Plans | Aetna-All Plans | $9,633 |
| Kaiser-All Other Plans | Kaiser-All Other Plans | $10,355 |
| Blue Shield Uc Care Members | Blue Shield Uc Care Members | $10,900 |
| UHC Jll | UHC Jll | $11,016 |
| Cigna-All Plans | Cigna-All Plans | $11,613 |
| UHC All Payer-All Other Plans | UHC All Payer-All Other Plans | $11,835 |
| First Health-All Plans | First Health-All Plans | $11,922 |
| Phcs-All Plans | Phcs-All Plans | $11,990 |
| Interplan-All Plans | Interplan-All Plans | $12,263 |
| Blue Shield-All Other Plans | Blue Shield-All Other Plans | $12,944 |
| Multiplan-All Plans | Multiplan-All Plans | $12,944 |
| Partnership Hp Mcal -All Plans | Partnership Hp Mcal -All Plans | $22,481 |
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