CT abdomen and pelvis with contrast at St. Charles Bend. CPT 74177.
What St. Charles Bend publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$3,895cash price (self-pay)
$4,869list price
$324–$4,772range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UMPQUA HEALTH [533] | Oregon Medicaid CCO | $324 |
| PRIMARY HEALTH OF JOSPEHINE COUNTY LLC [547] | Oregon Medicaid CCO | $324 |
| ALLCARE HEALTH PLAN [538] | Oregon Medicaid CCO | $324 |
| PACIFICSOURCE COMMUNITY SOLUTIONS [525] | PacificSource Central Oregon | $345 |
| PACIFICSOURCE COMMUNITY SOLUTIONS [525] | PacificSource Gorge & Lane C | $359 |
| PACIFICSOURCE COMMUNITY SOLUTIONS [525] | PacifcSource Healthier Orego | $382 |
| OREGON MEDICAID [500] | Oregon Medicaid | $409 |
| SAMARITAN HEALTH PLAN MED ADV [141] | Medicare - Non Contracted | $415 |
| Law Enforcement [701] | Schs Sbh/Srh Hb Law Enforcement | $415 |
| MEDICARE [100] | Medicare | $415 |
| MEDICARE AB REBILL ALT PAYER [175] | Medicare | $415 |
| NCT MEDICARE ALT PAYER [806] | Medicare | $415 |
| MEDICARE VACCINE [999100100] | PacificSource Medicare | $438 |
| PROVIDENCE MEDICARE ADV [137] | Providence Medicare | $482 |
| OTJ TRISTAR [673] | Oregon Workers Compensation | $506 |
| OTJ SEDGWICK [668] | Oregon Workers Compensation | $506 |
| OTJ SEDGWICK CMS [660] | Oregon Workers Compensation | $506 |
| OTJ PENSER NO AMERICAN [663] | Oregon Workers Compensation | $506 |
| OTJ PINNACLE RISK MGMT [661] | Oregon Workers Compensation | $506 |
| OTJ ESIS WEST WC CLAIMS [653] | Oregon Workers Compensation | $506 |
| OTJ CORVEL [676] | Oregon Workers Compensation | $506 |
| OTJ LIBERTY MUTUAL WAUSAU UNDERWRITERS [671] | Oregon Workers Compensa | $506 |
| OTJ GALLAGHER BASSETT [654] | Oregon Workers Compensation | $506 |
| OTJ HARTFORD [655] | Oregon Workers Compensation | $506 |
| AUTO USAA [611] | Auto Insurance | $506 |
| OTJ US DEPARTMENT OF LABOR [669] | US Dept of Labor | $519 |
| OTJ DEPT OF LABOR FEDERAL EMP [652] | US Dept of Labor | $519 |
| PROVIDENCE HEALTH PLAN [347] | Providence Health Plan PEBB OEBB | $831 |
| MODA [310] | Moda OEBB PEBB | $831 |
| REGENCE GROUP ADMINISTRATORS [203] | Blue Cross PPO | $1,319 |
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