CT abdomen and pelvis with contrast at Mount Sinai Behavioral Health Center. CPT 74177.
What Mount Sinai Behavioral Health Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$3,960cash price (self-pay)
$4,400list price
$318–$1,786range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| 1199 SEIU | Commercial | $318 |
| Aetna | Medicare Advantage | $435 |
| Cigna | LocalPlus | $671 |
| Empire | Individual Network | $764 |
| Empire | Small Group | $769 |
| Cigna | HMO/OAP | $808 |
| Cigna | PPO | $820 |
| Empire | Connection | $896 |
| Empire | Blue Priority HMO | $905 |
| Empire | Blue Priority PPO | $905 |
| Empire | Blue Access | $949 |
| Empire | HMO | $986 |
| Empire | PPO | $1,054 |
| Empire | Indemnity | $1,141 |
| Oxford | Commercial | $1,786 |
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