CT abdomen and pelvis with contrast at Sierra Vista Hospital. CPT 74177.
What Sierra Vista Hospital publishes for this service, straight from its standard-charges file, last updated January 10, 2026.
Outpatient / ER
$1,560cash price (self-pay)
$17,329list price
$448–$22,528range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cencal Mcr Adv - All Other Plans | Cencal Mcr Adv - All Other Plans | $448 |
| Aetna Mcr Adv | Aetna Mcr Adv | $448 |
| Tricare Blue Shield-All Plans | Tricare Blue Shield-All Plans | $448 |
| UHC Mcr Adv | UHC Mcr Adv | $448 |
| Cfmg-CA Forensic Med Grp Op/Profee Only-All Plans | Cfmg-CA Forensic M | $582 |
| Ah Employee Health Plan - All Plans | Ah Employee Health Plan - All Pl | $806 |
| Hpn-Heritage Prov Ntwrk-All Plans | Hpn-Heritage Prov Ntwrk-All Plans | $5,500 |
| UHC All Payer - All Other Plans | UHC All Payer - All Other Plans | $5,961 |
| UHC HMO | UHC HMO | $5,961 |
| UHC PPO | UHC PPO | $5,961 |
| Nbd-Ntwrks By Design Exclus-All Other Plans | Nbd-Ntwrks By Design Exc | $6,458 |
| Blue Shield Epn | Blue Shield Epn | $6,793 |
| Nbd-Ntwrks By Design Non-Exclus | Nbd-Ntwrks By Design Non-Exclus | $7,859 |
| Blue Shield HMO/POS | Blue Shield HMO/POS | $8,457 |
| Blue Shield EPO/PPO-All Other Plans | Blue Shield EPO/PPO-All Other Pl | $9,323 |
| Medi-Cal | Medi-Cal | $17,329 |
| Cencal Mcal | Cencal Mcal | $19,755 |
| Blue Shield Promise Mcal | Blue Shield Promise Mcal | $20,829 |
| Ccah-Centrl CA Allince Mcal-All Plans | Ccah-Centrl CA Allince Mcal-Al | $22,528 |
| Coalinga-All Plans | Coalinga-All Plans | $22,528 |
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