CT abdomen and pelvis with contrast at New York Eye and Ear Infirmary of Mount Sinai. CPT 74177.
What New York Eye and Ear Infirmary of Mount Sinai publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$64.76–$1,094range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare | Essential Plan | $86.34 |
| 1199 SEIU | Commercial | $318 |
| Cigna | Medicare Advantage | $435 |
| Horizon BCBS | Non Omnia | $459 |
| Horizon BCBS | Omnia | $459 |
| Cigna | LocalPlus | $671 |
| Empire | HMO | $799 |
| Cigna | HMO/OAP | $808 |
| Cigna | PPO | $889 |
| Empire | Connection | $930 |
| Empire | Blue Access | $935 |
| Empire | Blue Priority PPO | $981 |
| Empire | PPO | $1,094 |
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All common services at New York Eye and Ear Infirmary of Mount Sinai