CT abdomen and pelvis with contrast at Brigham City Community Hospital. CPT 74177.
What Brigham City Community Hospital publishes for this service, straight from its standard-charges file, last updated October 1, 2024.
Outpatient / ER
$9,055cash price (self-pay)
$9,055list price
$443–$2,617range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | IFPLP | $443 |
| Cigna | OAPNBN | $500 |
| Cigna | Exclusive | $575 |
| Regence | FocalPointPlus | $582 |
| Regence | FocalPoint | $648 |
| Regence | Individual | $770 |
| Regence | Preferred | $770 |
| Regence | RealValue | $770 |
| Regence | Participating | $947 |
| Regence | Traditional | $947 |
| Aetna | PeakPreference | $1,575 |
| Aetna | StandardNetwork | $2,064 |
| Aetna | AetnaSignatureAdministrators | $2,549 |
| Aetna | UtahConnectedNetwork | $2,617 |
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