CT abdomen and pelvis with contrast at Platte Valley Medical Center. CPT 74177.
What Platte Valley Medical Center publishes for this service, straight from its standard-charges file, last updated March 22, 2026.
Outpatient / ER
—cash price (self-pay)
$8,344list price
$359–$6,651range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Denv Hlth Med Plan | Denver Hlth Med Pl | $359 |
| Kaiser Perm PPO/POS | Kaiser Perm PPO/POS | $1,948 |
| Kaiser Perm PPO/POS | Kaiser PPO/POS Other | $1,948 |
| BCBS/Anthem | BCBS Co Exchange Plan | $2,103 |
| BCBS/Anthem | BCBS Co Federal | $2,103 |
| BCBS/Anthem | BCBS Co HMO | $2,103 |
| BCBS/Anthem | BCBS Co PPO | $2,103 |
| Cigna Scl Employees | Cigna Sclhs Cdhp | $2,979 |
| Choicecare Humana | Choicecare Humana HMO EPO | $3,505 |
| Choicecare Humana | Choicecare Humana PPO | $3,505 |
| United Healthcare | Selectcolorado | $4,623 |
| Cigna | Cigna HMO | $5,786 |
| Cigna | Cigna Indemnity | $5,786 |
| Cigna | Cigna Other | $5,786 |
| Cigna | Cigna POS/Qpos | $5,786 |
| Cigna | Cigna PPO | $5,786 |
| Cigna | Eighth Dist Elect Ben Pln | $5,786 |
| Cigna | Health-Partners | $5,786 |
| Geha | Geha | $6,167 |
| Geha | Geha Mcr Supplemental | $6,167 |
| United Healthcare | All Savers Alternative Funding | $6,167 |
| United Healthcare | Golden Rule Ins | $6,167 |
| United Healthcare | Healthscope | $6,167 |
| United Healthcare | Medica | $6,167 |
| United Healthcare | Surest | $6,167 |
| United Healthcare | UHC Charter/Navigate | $6,167 |
| United Healthcare | UHC Exchange Plan | $6,167 |
| United Healthcare | UHC Other/Supplemental | $6,167 |
| United Healthcare | Umr-United Med Resources | $6,167 |
| United Healthcare | United Healthcare | $6,167 |
Inpatient
—cash price (self-pay)
$8,344list price
$3,622–$6,496range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Kaiser Perm PPO/POS | Kaiser Perm PPO/POS | $3,622 |
| Kaiser Perm PPO/POS | Kaiser PPO/POS Other | $3,622 |
| Cigna | Cigna HMO | $5,786 |
| Cigna | Cigna Indemnity | $5,786 |
| Cigna | Cigna Other | $5,786 |
| Cigna | Cigna POS/Qpos | $5,786 |
| Cigna | Cigna PPO | $5,786 |
| Cigna | Eighth Dist Elect Ben Pln | $5,786 |
| Cigna | Health-Partners | $5,786 |
| BCBS/Anthem | BCBS Co Indemnity | $6,496 |
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