CT abdomen and pelvis with contrast at St. Elizabeth Community Hospital. CPT 74177.
What St. Elizabeth Community Hospital publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$5,737cash price (self-pay)
$9,824list price
$403–$9,628range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS - Anthem | Medicaid|All Plans | $403 |
| Aetna | Medicare|All Plans | $454 |
| BCBS - Anthem | Medicare|All Plans | $454 |
| Blue Shield CA | Medicare|All Plans | $454 |
| Health Net | Medicare|All Plans | $454 |
| Humana | Medicare|All Plans | $454 |
| Kaiser | Medicare|All Plans | $454 |
| United | Medicare|All Plans | $454 |
| California Health & Wellness | Medicaid|All Plans | $558 |
| Partnership Health Plan | Medicaid|All Plans | $1,212 |
| BCBS - Anthem | Commercial|Exchange | $4,814 |
| Blue Shield CA | Commercial|Exchange | $5,501 |
| BCBS - Anthem | Commercial|All Other Plans | $5,894 |
| Aetna | Commercial|All Other Plans | $6,877 |
| Aetna | Commercial|HMO | $6,877 |
| Aetna | Commercial|PPO | $6,877 |
| Blue Shield CA | Commercial|All Other Plans | $7,172 |
| Cigna | Commercial|All Other Plans | $7,172 |
| Cigna | Commercial|PPO | $7,172 |
| United | Commercial|All Other Plans | $8,842 |
| United | Commercial|HMO | $9,136 |
| Coventry | Commercial|All Plans | $9,628 |
| Health Net | Commercial|All Plans | $9,628 |
| MultiPlan | Commercial|All Plans | $9,628 |
Inpatient
$5,737cash price (self-pay)
$9,824list price
$5,501–$9,628range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Shield CA | Commercial|Exchange | $5,501 |
| Blue Shield CA | Commercial|All Other Plans | $7,172 |
| Cigna | Commercial|All Other Plans | $7,172 |
| Cigna | Commercial|PPO | $7,172 |
| Aetna | Commercial|All Other Plans | $7,270 |
| Aetna | Commercial|HMO | $7,270 |
| Aetna | Commercial|PPO | $7,270 |
| United | Commercial|All Other Plans | $8,842 |
| United | Commercial|HMO | $9,136 |
| Coventry | Commercial|All Plans | $9,628 |
| Health Net | Commercial|All Plans | $9,628 |
| MultiPlan | Commercial|All Plans | $9,628 |
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