CT abdomen and pelvis with contrast at Intermountain Health Cassia Regional Hospital. CPT 74177.
What Intermountain Health Cassia Regional Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$3,214cash price (self-pay)
$4,286list price
$85.32–$4,071range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Adv HMO | $218 |
| Aetna | Medicare Adv PPO | $218 |
| American Health | Medicare Adv UT HMO I-SNP | $218 |
| Blue Cross of Idaho | Medicare ID True Blue | $218 |
| Health Partners of Nevada | Medicare Advantage | $218 |
| Humana | Medicare Choice PPO | $218 |
| Molina | Medicare Choice Care HMO | $218 |
| Molina | Medicare Complete Care HMO SNP | $218 |
| Regence BCBS | Idaho UT Svc | $218 |
| SelectHealth | Medicare Advantage | $218 |
| St Lukes HP | Medicare Advantage | $218 |
| TriWest | Veterans Choice | $218 |
| UHC | Medicare Advantage | $218 |
| Regence | Blue Shield ID | $2,553 |
| BYU Athletics | Commercial | $2,639 |
| Deseret Mutual | All Other | $2,639 |
| Deseret Mutual | Select | $2,639 |
| PEHP | All Plans | $2,639 |
| PEHP | Capital Care | $2,639 |
| PEHP | Summit Exclusive | $2,639 |
| SelectHealth | All Plans | $2,639 |
| SelectHealth | Signature Individual ACA | $2,639 |
| UHC | Charter | $2,639 |
| UHC | Non-Options PPO | $2,639 |
| Blue Cross of Idaho | Exchange | $3,078 |
| Blue Cross of Idaho | Traditional/PPO | $3,313 |
| CorVel Corporation | Workers Comp | $3,643 |
| Corporation of the President | Workers Comp | $3,643 |
| Aetna | Standard | $4,071 |
| Campbell Scientific | Commercial | $4,071 |
Inpatient
$3,214cash price (self-pay)
$4,286list price
$3,257–$4,071range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross of Idaho | Exchange | $3,257 |
| Blue Cross of Idaho | Traditional/PPO | $3,429 |
| CorVel Corporation | Workers Comp | $3,643 |
| Corporation of the President | Workers Comp | $3,643 |
| Moda Health | Commercial | $3,643 |
| Regence | Blue Shield ID | $3,900 |
| Aetna | Standard | $4,071 |
| BYU Athletics | Commercial | $4,071 |
| Campbell Scientific | Commercial | $4,071 |
| Cigna | HMO | $4,071 |
| Cigna | PPO/EPO | $4,071 |
| Deseret Mutual | All Other | $4,071 |
| Deseret Mutual | Select | $4,071 |
| EMI Health | Mint | $4,071 |
| EMI Health | Network Care | $4,071 |
| EMI | Commercial | $4,071 |
| First Choice | Commercial | $4,071 |
| First Health | Commercial | $4,071 |
| Franklin County | Commercial | $4,071 |
| Global Excel | Commercial | $4,071 |
| Health Utah | Commercial | $4,071 |
| Juniper Systems | Commercial | $4,071 |
| LW Miller | Commercial | $4,071 |
| Managed Care Admin | Commercial | $4,071 |
| MedCare International | Commercial | $4,071 |
| Molina | CHIP | $4,071 |
| Molina | Marketplace | $4,071 |
| MotivHealth | Commercial | $4,071 |
| PEHP | All Plans | $4,071 |
| PEHP | Capital Care | $4,071 |
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All common services at Intermountain Health Cassia Regional Hospital