CT abdomen and pelvis with contrast at CHRISTUS Santa Rosa Hospital - Westover Hills. CPT 74177.
What CHRISTUS Santa Rosa Hospital - Westover Hills publishes for this service, straight from its standard-charges file, last updated January 13, 2026.
Outpatient / ER
$1,914cash price (self-pay)
$5,801list price
$168–$5,511range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | MM | $335 |
| Allwell | Superior Health MM | $335 |
| Blue Cross Blue Shield of Texas | MM | $335 |
| Christus Health | Med Adv MM | $335 |
| Coventry | First Health MM | $335 |
| Amerigroup | MM | $362 |
| Devoted Health Plan | MM | $362 |
| American Health Medicare | Advantage MM | $369 |
| Aetna | Chip KM | $464 |
| Aetna | Star KM | $464 |
| Blue Cross Blue Shield Of Texas | Star Chip KM | $464 |
| Community First | Chip KM | $464 |
| Community First | Star KM | $464 |
| Community First | Star Kids KM | $464 |
| Driscoll Children's Health Plan | Chip KM | $464 |
| Driscoll Children's Health Plan | Star KM | $464 |
| Driscoll Children's Health Plan | Star Kids KM | $464 |
| El Paso First | KM | $464 |
| Christus Health | HIX | $469 |
| Community First Health Plan | HMO | $673 |
| Amerigroup | Chip KM | $696 |
| Amerigroup | Star KM | $696 |
| Amerigroup | Star Kids KM | $696 |
| Amerigroup | Star Plus KM | $696 |
| Community First | Med Adv MM | $696 |
| Aetna | New Business | $821 |
| Aetna | EPO | $912 |
| Aetna | HMO | $912 |
| Aetna | POS | $912 |
| Aetna | PPO | $912 |
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All common services at CHRISTUS Santa Rosa Hospital - Westover Hills