CT abdomen and pelvis with contrast at Banner Churchill Community Hospital. CPT 74177.
What Banner Churchill Community Hospital publishes for this service, straight from its standard-charges file, last updated September 22, 2026.
Outpatient / ER
$2,302cash price (self-pay)
$4,697list price
$1,221–$4,556range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Commercial | $1,221 |
| Optum | Medicare | $1,503 |
| Banner Health | Banner Choice Plus/Banner Select | $1,644 |
| SilverSummit Healthplan | Medicare Advantage | $1,644 |
| TriWest Healthcare Alliance Corp - VA CCN | Tricare | $1,644 |
| Humana | Medicare Advantage | $1,743 |
| Hometown Health | HMO | $4,227 |
| Hometown Health | PPO/EPO | $4,227 |
| SilverSummit Healthplan | Commercial Exchange | $4,227 |
| United Healthcare | Commercial | $4,227 |
| Anthem Blue Cross Blue Shield Colorado | HMO/Indemnity/PPO/Pathway/Pat | $4,321 |
| Aetna | Medical Rental Products | $4,415 |
| Multiplan | Commercial | $4,415 |
| Cigna Healthcare & Life Insurance Company – WY | Commercial | $4,434 |
| Hometown Health | Lease Networks | $4,462 |
| Coventry | Commercial | $4,509 |
| Coventry | Workers Comp | $4,509 |
| Prominence HealthFirst (fka NV Preferred Healthcare Providers) | Comme | $4,556 |
Inpatient
$2,302cash price (self-pay)
$4,697list price
$4,227–$4,556range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Hometown Health | HMO | $4,227 |
| Hometown Health | PPO/EPO | $4,227 |
| SilverSummit Healthplan | Commercial Exchange | $4,227 |
| United Healthcare | Commercial | $4,227 |
| Anthem Blue Cross Blue Shield Colorado | HMO/Indemnity/PPO/Pathway/Pat | $4,321 |
| Multiplan | Commercial | $4,415 |
| Cigna Healthcare & Life Insurance Company – WY | Commercial | $4,434 |
| Hometown Health | Lease Networks | $4,462 |
| Coventry | Commercial | $4,509 |
| Coventry | Workers Comp | $4,509 |
| Prominence HealthFirst (fka NV Preferred Healthcare Providers) | Comme | $4,556 |
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