CT abdomen and pelvis with contrast at Mountain View Hospital. CPT 74177.
What Mountain View Hospital publishes for this service, straight from its standard-charges file, last updated March 16, 2026.
Outpatient / ER
$1,765cash price (self-pay)
$1,765list price
$326–$772range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana | ChoiceCare Medicare Advantage | $326 |
| Aetna | Medicare Advantage | $343 |
| Anasazi Medical Payment Solutions | Medicare Adv. | $343 |
| Blue Cross of ID | Medicare Advantage | $343 |
| Molina | Medicare Advantage and Dual Eligible | $343 |
| Mount Carmel Health Plan | Medicare Advantage | $343 |
| Optum Care Network ID | Medicare Advantage | $343 |
| PacificSource | Medicare Advantage | $343 |
| SelectHealth | Medicare Advantage | $343 |
| United Healthcare | Medicare Advantage | $343 |
| Moda | Select/Connexus | $772 |
| Molina | Marketplace | $772 |
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