CT abdomen and pelvis with contrast at Mission Hospital. CPT 74177.
What Mission Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$9,586cash price (self-pay)
$9,586list price
$828–$9,317range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United | AllPayerAppendix | $828 |
| BCBS | Mgmcd | $1,761 |
| United | BHMGMCD | $1,788 |
| WellCare | MGMCD | $1,814 |
| AmeriHealth | MGMCD | $1,831 |
| Partners Health Management | MGMCD | $1,849 |
| Vaya Health | MedicaidDirect | $1,849 |
| Vaya Health | MedicaidTailoredPlan | $1,849 |
| Apex Health | MCR | $1,917 |
| Cigna | Hix | $3,297 |
| Cigna | Ifp | $3,297 |
| CIGNA | NewBusiness | $3,460 |
| Caresource | Hix | $4,218 |
| United | GlobalBenefitPlanAppendix | $4,314 |
| CIGNA | ExistingBusiness | $4,419 |
| MedCost | ULTRARATE | $5,400 |
| United | OptionsPPO | $5,665 |
| Aetna | COMM | $6,739 |
| Multiplan | COMM | $7,669 |
| Avalon Administrative Services | COMM | $8,148 |
| MedCost | STANDARD | $8,148 |
| Prime Health | COMM | $8,435 |
| Prime Health | WCOMP | $8,435 |
| Prime Health | INDIGENTCARE | $8,627 |
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