CT abdomen and pelvis with contrast at Ascension St. John Sapulpa (St. John Sapulpa, Inc.). CPT 74177.
What Ascension St. John Sapulpa (St. John Sapulpa, Inc.) publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$1,188cash price (self-pay)
$3,210list price
$222–$616range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Whole Health | 2659_mcok, Baok, Ohok Aetna Whole Health 20241001 | $222 |
| Blue Cross Blue Shield Choice | 2723_spok Blue Cross Blue Shield Blue | $575 |
| Blue Cross Blue Shield Lincs | 2728_spok Blue Cross Blue Shield Blue L | $575 |
| Blue Cross Blue Shield Preferred | 2733_spok Blue Cross Blue Shield Bl | $575 |
| Blue Cross Blue Shield Traditional | 2738_spok Blue Cross Blue Shield | $575 |
| Blue Cross Blue Shield Blue Advantage | 2722_spok Blue Cross Blue Shie | $616 |
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All common services at Ascension St. John Sapulpa (St. John Sapulpa, Inc.)