CT abdomen and pelvis with contrast at Tri Valley Health System. CPT 74177.
What Tri Valley Health System publishes for this service, straight from its standard-charges file, last updated October 2, 2026.
Outpatient / ER
$5,056cash price (self-pay)
$5,618list price
$2,472–$5,506range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana Mcr Adv - All Plans | Humana Mcr Adv - All Plans | $2,472 |
| Medica Mcr Adv | Medica Mcr Adv | $2,472 |
| Wellcare Mcr Adv - All Plans | Wellcare Mcr Adv - All Plans | $2,472 |
| BCBS Mcr Adv | BCBS Mcr Adv | $2,472 |
| Medica Prime Sol | Medica Prime Sol | $2,472 |
| Tricare - All Plans | Tricare - All Plans | $2,472 |
| Great Plains Mcr Adv - All Plans | Great Plains Mcr Adv - All Plans | $2,596 |
| Molina Mcaid - All Plans | Molina Mcaid - All Plans | $2,697 |
| Nebraska Total Care-All Plans | Nebraska Total Care-All Plans | $2,697 |
| Healthy Blue Mcaid - All Plans | Healthy Blue Mcaid - All Plans | $2,697 |
| UHC Comm Plan Mcaid | UHC Comm Plan Mcaid | $2,697 |
| BCBS - All Other Plans | BCBS - All Other Plans | $2,721 |
| Amerigroup Mcaid - All Plans | Amerigroup Mcaid - All Plans | $2,751 |
| Medica Chi Aco - All Other Plans | Medica Chi Aco - All Other Plans | $5,056 |
| Medica Ifb Aco | Medica Ifb Aco | $5,056 |
| Medica Ifb Open Access | Medica Ifb Open Access | $5,056 |
| Medica Chi Open Access | Medica Chi Open Access | $5,056 |
| Midlands Choice-All Plans | Midlands Choice-All Plans | $5,056 |
| BCBS Blue Print | BCBS Blue Print | $5,112 |
| UHC Comm -All Other Plans | UHC Comm -All Other Plans | $5,393 |
| Aetna Advantra HMO | Aetna Advantra HMO | $5,506 |
| Aetna Employer | Aetna Employer | $5,506 |
| Aetna PPO/HMO - All Other Plans | Aetna PPO/HMO - All Other Plans | $5,506 |
| Multiplan-All Plans | Multiplan-All Plans | $5,506 |
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