CT abdomen and pelvis with contrast at Simi Valley Hospital And Health Care Services. CPT 74177.
What Simi Valley Hospital And Health Care Services publishes for this service, straight from its standard-charges file, last updated May 21, 2026.
Outpatient / ER
$1,446cash price (self-pay)
$9,035list price
$250–$8,132range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Ehn - All Plans | Ehn - All Plans | $250 |
| Blue Shield Mcare | Blue Shield Mcare | $449 |
| Facey Medical Mdcare | Facey Medical Mdcare | $449 |
| Medicare 1/1/21 | Medicare 1/1/21 | $449 |
| Tricare Blue Shield - All Plans | Tricare Blue Shield - All Plans | $449 |
| UHC Mcr Adv | UHC Mcr Adv | $449 |
| Gold Coast Mcal - All Plans | Gold Coast Mcal - All Plans | $497 |
| Facey Medical HMO/POS - All Other Plans | Facey Medical HMO/POS - All | $538 |
| Hpn Senior HMO | Hpn Senior HMO | $580 |
| UHC HMO | UHC HMO | $597 |
| UHC Jll | UHC Jll | $597 |
| Hpn - All Other Plans | Hpn - All Other Plans | $747 |
| Ah Employee Health Plan - All Plans | Ah Employee Health Plan - All Pl | $808 |
| Centivo - All Plans | Centivo - All Plans | $1,010 |
| Bc Exchange | Bc Exchange | $1,130 |
| Cigna All Other - All Other Plans | Cigna All Other - All Other Plans | $1,191 |
| Cigna HMO | Cigna HMO | $1,191 |
| Bc Non Mcs | Bc Non Mcs | $1,256 |
| Bc Mcs - All Other Plans | Bc Mcs - All Other Plans | $1,507 |
| Health Net - All Plans | Health Net - All Plans | $1,810 |
| Scan Mcr Adv - All Plans | Scan Mcr Adv - All Plans | $2,500 |
| Vchcp - All Plans | Vchcp - All Plans | $3,614 |
| UHC All Payer - All Other Plans | UHC All Payer - All Other Plans | $3,750 |
| Western Growers - All Plans | Western Growers - All Plans | $3,795 |
| Blue Shield - All Other Plans | Blue Shield - All Other Plans | $4,147 |
| Kaiser - All Plans | Kaiser - All Plans | $4,518 |
| Aetna - All Plans | Aetna - All Plans | $4,969 |
| First Health - All Plans | First Health - All Plans | $5,873 |
| Phcs PPO - All Plans | Phcs PPO - All Plans | $5,873 |
| Beech Street PPO - All Plans | Beech Street PPO - All Plans | $6,776 |
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All common services at Simi Valley Hospital And Health Care Services