CT abdomen and pelvis with contrast at White Memorial Medical Center. CPT 74177.
What White Memorial Medical Center publishes for this service, straight from its standard-charges file, last updated May 23, 2026.
Outpatient / ER
$2,556cash price (self-pay)
$14,198list price
$85.22–$21,723range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Shield Mcr Adv | Blue Shield Mcr Adv | $85.22 |
| Bc Medi-Cal | Bc Medi-Cal | $102 |
| Access Group | Access Group | $381 |
| Lasalle Mg Commercial - All Other Plans | Lasalle Mg Commercial - All | $381 |
| Access Medi-Cal | Access Medi-Cal | $404 |
| Alta Los Angeles Mcal 1/1/19 | Alta Los Angeles Mcal 1/1/19 | $404 |
| Bella Vista Medi-Cal Op/Profee Only | Bella Vista Medi-Cal Op/Profee O | $404 |
| Pacific Ipa Medi-Cal | Pacific Ipa Medi-Cal | $404 |
| Altamed Connect | Altamed Connect | $449 |
| Avanti Mcr Adv - All Other Plans | Avanti Mcr Adv - All Other Plans | $449 |
| Brand New Day Mcare - All Plans | Brand New Day Mcare - All Plans | $449 |
| Care First Mcare - All Other Plans | Care First Mcare - All Other Plan | $449 |
| Clever Care - All Plans | Clever Care - All Plans | $449 |
| Humana Mcare - All Plans | Humana Mcare - All Plans | $449 |
| Lasalle Mg Senior | Lasalle Mg Senior | $449 |
| Pacific Alliance Mcare - All Other Plans | Pacific Alliance Mcare - Al | $449 |
| Altamed Medi-Cal - All Other Plans | Altamed Medi-Cal - All Other Plan | $465 |
| Blue Cross Mcr Adv | Blue Cross Mcr Adv | $467 |
| Fcs Ipa Op/Profee Only - All Other Plans | Fcs Ipa Op/Profee Only - Al | $471 |
| Fcs Ipa Medi-Cal Op/Profee Only | Fcs Ipa Medi-Cal Op/Profee Only | $485 |
| Caremore Mcare - All Plans | Caremore Mcare - All Plans | $514 |
| Aetna - All Plans | Aetna - All Plans | $1,150 |
| Blue Cross Non Mcs | Blue Cross Non Mcs | $1,384 |
| Care First Medi-Cal | Care First Medi-Cal | $1,415 |
| Cigna | Cigna | $1,536 |
| Cigna All Other - All Other Plans | Cigna All Other - All Other Plans | $1,536 |
| Healthnet Comm Care | Healthnet Comm Care | $1,713 |
| La Care Mcr Adv - All Plans | La Care Mcr Adv - All Plans | $2,000 |
| Healthcare Inc - All Other Plans | Healthcare Inc - All Other Plans | $3,245 |
| Blue Shield - All Other Plans | Blue Shield - All Other Plans | $3,933 |
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