CT abdomen and pelvis with contrast at Palo Alto County Health System. CPT 74177.
What Palo Alto County Health System publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$3,404cash price (self-pay)
$4,702list price
$1,056–$4,620range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross | Medicare | $1,094 |
| Wellpoint | Medicare | $1,094 |
| Humana | Medicare | $1,116 |
| Medigold | Medicare | $2,257 |
| UHC | Medicare | $2,257 |
| United Behavioral Health | Medicare | $2,257 |
| Wellpoint | Medicaid | $3,050 |
| Molina | Medicaid | $3,064 |
| Corvel | Work Comp | $4,231 |
| Midlands Choice | Commercial | $4,466 |
Inpatient
$3,404cash price (self-pay)
$4,702list price
$3,086–$4,864range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross | HMO | $3,197 |
| Blue Cross | PPO | $3,197 |
| Medigold | Medicare | $3,460 |
| UHC | Medicare | $3,460 |
| United Behavioral Health | Medicare | $3,460 |
| Blue Cross | Medicare | $3,494 |
| Wellpoint | Medicare | $3,494 |
| Humana | Medicare | $3,563 |
| Corvel | Work Comp | $4,231 |
| Midlands Choice | Commercial | $4,466 |
| Iowa Total Care | Medicaid | $4,702 |
| Molina | Medicaid | $4,702 |
| Wellpoint | Medicaid | $4,702 |
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