CT abdomen and pelvis with contrast at Roosevelt Medical Center. CPT 74177.
What Roosevelt Medical Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$2,483cash price (self-pay)
$2,483list price
$2,235–$2,483range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Three Rivers Provider Network | TRPN workers Comp | $2,235 |
| UnitedHeathcare | PPO | $2,334 |
| Mountain Health Co-op | PPO/POS | $2,334 |
| Blue Cross Blue Sheild | PPO | $2,334 |
| Three Rivers Provider Network | TRPN commercial plans | $2,433 |
| EBMS | SelectCare Network | $2,433 |
| Allegiance | PPO | $2,433 |
| PacificSource | PPO | $2,433 |
| Interwest | PPO | $2,458 |
| First Choice Health Network | Standard/Equitable Plans | $2,458 |
| Blue Cross Blue Shield | Traditional | $2,483 |
| Interwest | Traditional Network | $2,483 |
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