CT abdomen and pelvis with contrast at St Helena Hospital. CPT 74177.
What St Helena Hospital publishes for this service, straight from its standard-charges file, last updated July 15, 2026.
Outpatient / ER
$56.10cash price (self-pay)
$7,496list price
$13.33–$10,013range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medi-Cal | Medi-Cal | $282 |
| Va Medi-Cal | Va Medi-Cal | $404 |
| Blue Shield Mcr Adv | Blue Shield Mcr Adv | $463 |
| Tricare Blue Shield | Tricare Blue Shield | $463 |
| Blue Shield Bh Mcr Adv | Blue Shield Bh Mcr Adv | $463 |
| Kaiser Mcr Adv | Kaiser Mcr Adv | $463 |
| UHC Mcr Adv | UHC Mcr Adv | $463 |
| Va Mcr - All Other Plans | Va Mcr - All Other Plans | $463 |
| Ah Employee Health Plan - All Plans | Ah Employee Health Plan - All Pl | $834 |
| Healthnet-All Plans | Healthnet-All Plans | $1,060 |
| Blue Cross Exchange | Blue Cross Exchange | $1,066 |
| Blue Cross Non Mcs | Blue Cross Non Mcs | $1,185 |
| Blue Cross Mcs - All Other Plans | Blue Cross Mcs - All Other Plans | $1,422 |
| Aetna-All Plans | Aetna-All Plans | $1,646 |
| UHC Select/Select Plus | UHC Select/Select Plus | $3,323 |
| Blue Shield Non-Epn | Blue Shield Non-Epn | $3,478 |
| Blue Shield Epn-All Other Plans | Blue Shield Epn-All Other Plans | $3,531 |
| UHC Jll | UHC Jll | $3,579 |
| UHC All Payer - All Other Plans | UHC All Payer - All Other Plans | $3,767 |
| Western Growers-All Plans | Western Growers-All Plans | $3,973 |
| Phcs-All Plans | Phcs-All Plans | $4,123 |
| UHC Options PPO | UHC Options PPO | $4,779 |
| Interplan-All Plans | Interplan-All Plans | $4,872 |
| Blue Shield Behav Hlth | Blue Shield Behav Hlth | $5,007 |
| Cigna-All Other Plans | Cigna-All Other Plans | $5,997 |
| Kaiser-All Other Plans | Kaiser-All Other Plans | $6,147 |
| Health Management Network-All Plans | Health Management Network-All Pl | $6,372 |
| Three Rivers-All Plans | Three Rivers-All Plans | $6,746 |
| Umr UHC PPO | Umr UHC PPO | $7,082 |
| Choicecare-All Plans | Choicecare-All Plans | $7,788 |
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