CT abdomen and pelvis with contrast at San Lucas Metro. CPT 74177.
What San Lucas Metro publishes for this service, straight from its standard-charges file, last updated March 20, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$138–$275range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Acaa | Acaa | $138 |
| IMC Comercial | IMC Comercial | $138 |
| Menonita Vital | Menonita Vital | $183 |
| Plan de Salud Menonita | Plan de Salud Menonita | $191 |
| Mapfre | Mapfre | $200 |
| MCS Comercial | MCS Comercial | $210 |
| MCS Advantage | MCS Advantage | $210 |
| Humana Advantage | Humana Advantage | $215 |
| Triple S | Triple S | $225 |
| Prossam | Prossam | $225 |
| Triple S Blue Select | Triple S Blue Select | $225 |
| Triple S Advantage | Triple S Advantage | $225 |
| Triple S Vital | Triple S Vital | $235 |
| First Medical Vital | First Medical Vital | $235 |
| MMM Vital | MMM Vital | $235 |
| Comprensive Humana Services (CHS) | Comprensive Humana Services (CHS) | $275 |
| Medicare | Medicare | $275 |
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