CT abdomen and pelvis with contrast at Cypress Pointe Surgical Hospital. CPT 74177.
What Cypress Pointe Surgical Hospital publishes for this service, straight from its standard-charges file, last updated July 17, 2026.
Outpatient / ER
$633cash price (self-pay)
$1,199list price
$179–$872range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Better Health | Medicaid | $179 |
| Healthy Blue | Medicaid | $179 |
| Humana Healthy Horizons | Medicaid | $179 |
| LA Healthcare Connections | Medicaid | $179 |
| Humana | Medicare Advantage | $310 |
| Aetna | Medicare Advantage | $317 |
| Blue Cross | Medicare Advantage | $317 |
| Coventry | Medicare Advantage | $317 |
| Peoples Health | Medicare Advantage | $317 |
| United Health | Medicare Advantage | $317 |
| TriWest | TriWest | $357 |
| Blue Cross | HMO | $371 |
| United Health | Commercial UMR | $382 |
| Humana | Commercial | $383 |
| Blue Cross | PPO Fed POS | $391 |
| Aetna | Commercial | $396 |
| Coventry | Commercial | $427 |
| PPO Plus | Commercial | $507 |
| Prove Partners | Prove Partners | $540 |
| HMR Funding | HMR Funding | $540 |
| LUBA | Workers Comp | $570 |
| DMA Funding | DMA Funding | $600 |
| LWCC | Workers Comp | $872 |
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