CT abdomen and pelvis with contrast at Golden Valley Memorial Hospital. CPT 74177.
What Golden Valley Memorial Hospital publishes for this service, straight from its standard-charges file, last updated July 1, 2026.
Outpatient / ER
$146cash price (self-pay)
$5,400list price
$344–$806range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Home State Health | Managed Medicaid | $344 |
| United Healthcare | Community Care Medicaid | $344 |
| Aetna | Medicare Advantage | $372 |
| Humana | Medicare Advantage | $372 |
| United Healthcare | Medicare Advantage | $372 |
| United Healthcare | VA CCN | $372 |
| Ambetter | Medicare Advantage | $447 |
| United Healthcare | Exchange Commercial | $633 |
| Medica | Individual/Family | $806 |
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