CT abdomen and pelvis with contrast at UCLA Santa Monica Medical Center. CPT 74177.
What UCLA Santa Monica Medical Center publishes for this service, straight from its standard-charges file, last updated March 29, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$282–$1,288range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| LA care Medi-Cal HMO | Medi-Cal HMO | $282 |
| Aetna Medicare | Medicare | $449 |
| Redlands Community Medicare | Medicare | $449 |
| St. Jude | Medicare HMO | $449 |
| TriWest Healthcare Alliance | Other Government | $449 |
| UCLA Health Medicare Advantage Plan | Medicare Advantage | $449 |
| Health Plan of Nevada Medicare | Medicare | $453 |
| Blue Shield | Medicare Advantage | $454 |
| LA Care DSNP | Medicare HMO | $454 |
| Monarch | Medicare | $454 |
| UHC Mediare Advantage | Medicare Advantage | $454 |
| Anthem Vivity-Anthem HMO | All Products-HMO | $494 |
| Providence Healthcare | Medicare | $499 |
| Torrance Memorial Medicare | HMO-Medicare | $499 |
| HealthSmart | Workers Compensation | $538 |
| Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $555 |
| Central Health Plan | Medicare HMO | $577 |
| SCAN | Medicare | $613 |
| LA Care Covered CA | HMO | $673 |
| Centivo | PPO | $1,077 |
| Health Plan of Nevada Commercial | All Products | $1,250 |
| Optum | Medicare | $1,288 |
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