CT abdomen and pelvis with contrast at UCLA West Valley Medical Center. CPT 74177.
What UCLA West Valley 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–$1,089range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| LA Care Medi-Cal | MEDI-CAL | $282 |
| HealthCare Partners HMO | HMO-Medicare | $449 |
| TriWest Healthcare Alliance | Other Government | $449 |
| UCLA Health Medicare Advantage Plan | Medicare Advantage | $449 |
| Health Net Medicare | MEDICARE ADVANTAGE | $453 |
| Aetna Medicare Advantage | MEDICARE ADVANTAGE | $454 |
| Anthem Medicare Advantage | MEDICARE ADVANTAGE | $454 |
| Blue Shield of California | Medicare Advantage | $454 |
| LA Care Medicare_DSNP | MEDICARE ADVANTAGE_DSNP | $454 |
| UHC Medicare | MEDICARE ADVANTAGE | $454 |
| LA Care Commercial | PASC | $535 |
| LA Care Commercial | Covered CA | $567 |
| Anthem Workers Comp | WORKERS COMP | $614 |
| Anthem Vivity, Anthem HMO | HMO-City of LA | $614 |
| Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $692 |
| Centivo | PPO | $1,089 |
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