CT abdomen and pelvis with contrast at Ascension St. Vincent's Riverside (St. Vincent's Medical Center, Inc.). CPT 74177.
What Ascension St. Vincent's Riverside (St. Vincent's Medical Center, Inc.) publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$693cash price (self-pay)
$1,873list price
$348–$824range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana PPO Mcr Replacement | 1535_medicare Advantage Humana PPO Outpat | $351 |
| Bc Advantage Mcr Replacement | 1527_medicare Advantage Blue Cross Outp | $358 |
| Blue Cross Alignment | 1526_medicare Advantage Alignment Healthcare Ou | $358 |
| Community Hospice | 1530_medicare Advantage Community Hospice Outpatie | $358 |
| Coventry Mcr Replacement HMO | 1531_medicare Advantage Coventry HMO Ou | $358 |
| Haven Hospice | 1532_medicare Advantage Haven Hospice Outpatient 20250 | $358 |
| Heartland Of Hc | 1533_medicare Advantage Heartland Hc Outpatient 2025 | $358 |
| Medicare Other (No Seq) | 1518_medicare Advantage (No Seq) Outpatient | $358 |
| Medicare Replacement | 1537_medicare Advantage Outpatient 20250101 | $358 |
| Pace Place | 1607_pace Program Outpatient 20190301 | $358 |
| Research Study Encore Borland-Groover | 1580_research Study Encore-Bor | $358 |
| Veterans Administration | 1522_veterans Administration Outpatient 2025 | $358 |
| Wellcare | 1574_medicare Advantage Wellcare Outpatient 20250101 | $358 |
| Cigna Healthspring | 1524_cigna Healthspring Outpatient 20250101 | $362 |
| Humana HMO Mcr Replacement | 1534_medicare Advantage Humana HMO Outpat | $362 |
| UHC Wellmed Mcr Replacement | 1605_medicare Advantage United Health CA | $362 |
| Careplus Mcr Replacement | 1529_medicare Advantage Careplus Outpatient | $366 |
| Gold Kidney Medicare Advantage | 1562_gold Kidney Medicare Advantage O | $366 |
| Aetna Mcr Replacement | 1525_medicare Advantage Aetna Outpatient 20250 | $369 |
| Cigna HMO New Business | 1594_cigna HMO New Business 20250701 | $375 |
| Smarthealth | 1540_smarthealth Outpatient 20250101 | $502 |
| Bright Health | 1528_medicare Advantage Bright Health Outpatient 20250 | $520 |
| Aetna Qualified Health Plans | 1515_aetna Qualified Health Plan (Qhp) | $556 |
| Aetna Whole Health | 1516_aetna Whole Health Outpatient 20250101 | $556 |
| Oscar Health Plan | 1549_oscar Health Plan Outpatient 20250401 | $574 |
| Employer Direct Healthcare | 1625_employer Direct Healthcare Outpatien | $627 |
| 90 Degree Benefits | 1517_90 Degree Benefits Outpatient 20250101 | $645 |
| Avmed Exchange | 1609_avmed Exchange Outpatient 20250201 | $645 |
| Molina Exchange | 1520_molina Exchange Outpatient 20250101 | $663 |
| Occunet | 1519_medicare Advantage Occunet Outpatient 20250101 | $663 |
Inpatient
—cash price (self-pay)
—list price
$348–$807range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana HMO Cardiology Mcr Replacement | 1662_medicare Advantage Humana | $348 |
| Bc Advantage Mcr Replacement | 1656_medicare Advantage Blue Cross Inpa | $358 |
| Blue Cross Alignment | 1655_medicare Advantage Alignment Healthcare In | $358 |
| Coventry Mcr Replacement HMO | 1659_medicare Advantage Coventry HMO In | $358 |
| Heartland Of Hc | 1660_medicare Advantage Heartland Hc Inpatient 20251 | $358 |
| Humana PPO Mcr Replacement | 1664_medicare Advantage Humana PPO Inpati | $358 |
| Medicare Other (No Seq) | 1653_medicare Advantage (No Seq) Inpatient 2 | $358 |
| Medicare Replacement | 1665_medicare Advantage Inpatient 20251001 | $358 |
| Pace Place | 1673_pace Program Inpatient 20251001 | $358 |
| Research Study Encore Borland-Groover | 1674_research Study Encore-Bor | $358 |
| Veterans Administration | 1678_veterans Administration Inpatient 20251 | $358 |
| Wellcare | 1668_medicare Advantage Wellcare Inpatient 20251001 | $358 |
| Humana HMO Mcr Replacement | 1663_medicare Advantage Humana HMO Inpati | $362 |
| UHC Wellmed Mcr Replacement | 1667_medicare Advantage United Health CA | $362 |
| Careplus Mcr Replacement | 1658_medicare Advantage Careplus Inpatient | $366 |
| Cigna Healthspring | 1650_cigna Healthspring Inpatient 20251001 | $366 |
| Gold Kidney Medicare Advantage | 1652_gold Kidney Medicare Advantage I | $366 |
| Aetna Mcr Replacement | 1654_medicare Advantage Aetna Inpatient 202510 | $369 |
| Bright Health | 1657_medicare Advantage Bright Health Inpatient 202510 | $484 |
| Smarthealth | 1675_smarthealth Inpatient 20251001 | $502 |
| Aetna Qualified Health Plans | 1647_aetna Qualified Health Plan (Qhp) | $556 |
| Aetna Whole Health | 1648_aetna Whole Health Inpatient 20251001 | $556 |
| Oscar Health Plan | 1671_oscar Health Plan Inpatient 20251001 | $574 |
| Employer Direct Healthcare | 1624_employer Direct Healthcare Inpatient | $627 |
| 90 Degree Benefits | 1644_90 Degree Benefits Inpatient 20251001 | $645 |
| Avmed Exchange | 1649_avmed Exchange Inpatient 20251001 | $645 |
| Molina Exchange | 1670_molina Exchange Inpatient 20251001 | $663 |
| Ambetter Commercial-Exchange | 1676_sunshine Ambetter Exchange Commerc | $681 |
| Aetna New Business Discount | 1646_aetna New Business Discount Inpatie | $735 |
| Occunet | 1666_medicare Advantage Occunet Inpatient 20251001 | $807 |
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All common services at Ascension St. Vincent's Riverside (St. Vincent's Medical Center, Inc.)