CT abdomen and pelvis with contrast at Santa Rosa Memorial Hospital. CPT 74177.
What Santa Rosa Memorial Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$3,564cash price (self-pay)
$11,456list price
$485–$2,402range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Healthnet | Medicare Managed Care Plan | $485 |
| Aetna | Medicare Managed Care Plan | $495 |
| Unitedhealthcare | All Commercial Plans | $611 |
| Unitedhealthcare | Select/Navigate Hmo | $611 |
| Blue Cross | Epo Exchange | $1,674 |
| Aetna | All Commercial Plans | $1,762 |
| Blue Cross | Nonmcs All Commercial Plans | $2,002 |
| Blue Cross | Mcs All Commercial Plans | $2,402 |
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