CT abdomen and pelvis with contrast at Cibola General Hospital. CPT 74177.
What Cibola General Hospital publishes for this service, straight from its standard-charges file, last updated March 11, 2026.
Outpatient / ER
$1,161cash price (self-pay)
$4,975list price
$352–$4,477range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Bcbs_nm_turquoise | BCBS Turquoise Care | $352 |
| Presby_turquoise | Presbyterian Turquoise Care | $352 |
| Molina_turquoise | Molina Turquoise Care | $493 |
| Cigna | Cigna | $535 |
| Uhc_turquoise | UHC Turquoise Care | $623 |
| Tricare | Tricare | $2,207 |
| Medicare | Medicare | $2,239 |
| Presbyterian_srcare | Presbyterian Senior Care | $2,239 |
| Uhc_mcradv | United Healthcare Medicare Advantage | $2,239 |
| Core_civic | Core Civic | $2,261 |
| Humana_mcradv | Humana Medicare Advantage | $2,261 |
| Bcbsnm_community_hmo | BCBS New Mexico Community HMO | $3,617 |
| Selfpay | Self Pay | $3,980 |
| Bcbsnm_bav | BCBS New Mexico Blue Advantage HMO | $4,229 |
| Bcbs_nm | Blue Cross Blue Shield New Mexico | $4,229 |
| Presbyterian_health | Presbyterian Health Commercial | $4,229 |
| Zelis | Zelis | $4,229 |
| First_health | Aetna - Coventry - First Health | $4,378 |
| Humana | Humana | $4,477 |
| UHC | United Healthcare Commercial | $4,477 |
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