CT abdomen and pelvis with contrast at Portneuf Medical Partners. CPT 74177.
What Portneuf Medical Partners publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$1,879cash price (self-pay)
$3,132list price
$179–$2,975range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Healthscope Benefits [2290] | Healthscope Ardent [229001] | $645 |
| Umr - Ardent Employee [2036] | Umr - Ardent Employee [203601] | $645 |
| Oncology Patient Assistance Programs [2295] | Bccs Family Circle Of CA | $1,284 |
| Moda Health [6100] | Moda Health [610000] | $1,284 |
| Lucent Health [6000] | Lucent Health [600000] | $1,284 |
| Pending Ssi [1616] | Pending Ssi Rca [161601] | $1,284 |
| Black Lung [6055] | Black Lung [605500] | $1,284 |
| Web Tpa [2115] | Web Tpa Healthcare Highways [211504] | $1,284 |
| Employee Benefit Management Services [2445] | Employee Benefit Managem | $1,284 |
| Healthcare Highways [2210] | Hch 90 Degree Benefits [221013] | $1,284 |
| Healthcare Highways [2210] | Hch John Soules Foods [221011] | $1,284 |
| Healthcare Highways [2210] | Hch Broken Arrow [221012] | $1,284 |
| Pacific Source Health Plans [2850] | Pacific Source Health Plans [2850 | $1,800 |
| Liberty Health Share Lhs/Medcost Solutions LLC [2400] | Liberty Health | $1,879 |
| Medishare Christian Care [1645] | Medishare Christian Care [164500] | $1,879 |
| Employee Benefit Management Services [2445] | Ebms Bingham Memorial Ho | $1,879 |
| Cigna [1260] | Cigna PPO [126025] | $2,305 |
| First Health [1375] | Tall Tree Administrators [137514] | $2,584 |
| First Health [1375] | Meritain Health First Health [137516] | $2,584 |
| Selecthealth [3740] | Selecthealth Med Network [3740003] | $2,656 |
| Humana Commercial [2140] | Humana Choicecare [214003] | $2,819 |
| Geha [1415] | Geha - Asa [141503] | $2,819 |
| Selecthealth [3740] | Selecthealth [374000] | $2,819 |
| United Healthcare [2060] | United Healthcare Student Svc [206012] | $2,819 |
| United Healthcare [2060] | UHC Surest Bind [206032] | $2,819 |
| Umr [2035] | Umr United Healthcare [203502] | $2,819 |
| Umr [2035] | United Medical Resources [203503] | $2,819 |
| Mutual Of Omaha [1685] | Mutual Of Omaha [168500] | $2,975 |
| New Era Life Insurance Company [1705] | Philadelphia American Life [17 | $2,975 |
| Planned Administrators Inc [2360] | Planned Administrators Inc [236000 | $2,975 |
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