CT abdomen and pelvis with contrast at Otto Kaiser Memorial Hospital. CPT 74177.
What Otto Kaiser Memorial Hospital publishes for this service, straight from its standard-charges file, last updated June 9, 2026.
Outpatient / ER
$3,805cash price (self-pay)
$3,805list price
$462–$3,614range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Superior STAR | Managed Medicaid | $462 |
| Superior CHIP | Managed Medicaid | $462 |
| Superior Foster Kids | Managed Medicaid | $462 |
| Superior Perinate | Managed Medicaid | $462 |
| Superior Star+Plus | Managed Medicaid | $462 |
| United HealthCare | Managed Medicaid | $485 |
| Humana | PPO | $700 |
| Aetna Health Inc. | Medicare Advantage | $2,245 |
| Christus Exchange | Commercial | $2,245 |
| Multiplan | Workers Compensation | $2,245 |
| Sedgewick | Workers Compensation | $2,245 |
| Triwest Va | Commercial | $2,245 |
| United HealthCare | Medicare Advantage | $2,245 |
| Humana | Medicare Advantage | $2,267 |
| AllWell | Medicare Advantage | $2,357 |
| Provider Partners Health | Medicare Advantage | $2,581 |
| Texas Independence Health | Medicare Advantage | $2,581 |
| Cigna HealthCare | Commercial | $2,625 |
| CorCare Healthcare | Commercial | $2,663 |
| United HealthCare | Commercial | $2,968 |
| IMS | Commercial | $3,424 |
| Multiplan PHCS | Commercial | $3,424 |
| Blue Cross Blue Shield | Traditional Indemnity | $3,614 |
| Blue Cross Blue Shield | PPO/POS Network | $3,614 |
| Blue Cross Blue Shield | Essentials Network | $3,614 |
| Coventry | Commercial | $3,614 |
| Coventry | Workers Compensation | $3,614 |
| Galaxy Health Network | Commercial | $3,614 |
| HealthSmart | Commercial | $3,614 |
| Omni | Commercial | $3,614 |
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