CT abdomen and pelvis with contrast at Intermountain Health Bear River Valley Hospital. CPT 74177.
What Intermountain Health Bear River Valley Hospital publishes for this service, straight from its standard-charges file, last updated August 5, 2026.
Outpatient / ER
$3,214cash price (self-pay)
$4,286list price
$85.32–$4,114range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Adv HMO | $218 |
| Aetna | Medicare Adv PPO | $218 |
| American Health | Medicare Adv UT HMO I-SNP | $218 |
| Health Partners of Nevada | Medicare Advantage | $218 |
| Health Plan of Nevada | Medicaid | $218 |
| Healthy U | Medicaid | $218 |
| Humana | Medicare Choice PPO | $218 |
| Molina | Medicaid | $218 |
| Molina | Medicare Choice Care HMO | $218 |
| Molina | Medicare Complete Care HMO SNP | $218 |
| Regence BCBS | MedAdvantage PPO | $218 |
| SelectHealth | Medicaid | $218 |
| SelectHealth | Medicare Advantage | $218 |
| UHC | Medicare Advantage | $218 |
| AG Administrators | USU Athletics | $2,639 |
| Aetna | Standard | $2,639 |
| BYU Athletics | Commercial | $2,639 |
| Campbell Scientific | Commercial | $2,639 |
| Cigna | HMO | $2,639 |
| Cigna | PPO/EPO | $2,639 |
| Deseret Mutual | All Other | $2,639 |
| Deseret Mutual | Select | $2,639 |
| EMI Health | Mint | $2,639 |
| EMI Health | Network Care | $2,639 |
| EMI | Commercial | $2,639 |
| Franklin County | Commercial | $2,639 |
| Health Utah | Commercial | $2,639 |
| Intermountain Caregiver Plan | Med Network | $2,639 |
| Juniper Systems | Commercial | $2,639 |
| LW Miller | Commercial | $2,639 |
Inpatient
$3,214cash price (self-pay)
$4,286list price
$3,214–$4,071range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Injury Care of Nevada | Workers Comp | $3,214 |
| BYU Risk Management | Workers Comp | $3,643 |
| CorVel Corporation | Workers Comp | $3,643 |
| Corporation of the President | Workers Comp | $3,643 |
| Health Plan of Nevada | Medicaid | $3,814 |
| Healthy U | Medicaid | $3,814 |
| Molina | Medicaid | $3,814 |
| AG Administrators | USU Athletics | $4,071 |
| AWH Connected | Connected Utah | $4,071 |
| Aetna | Connected | $4,071 |
| Aetna | Extended | $4,071 |
| Aetna | Standard | $4,071 |
| BYU Athletics | Commercial | $4,071 |
| Campbell Scientific | Commercial | $4,071 |
| Cigna | HMO | $4,071 |
| Cigna | Open Access Flex | $4,071 |
| Cigna | PPO/EPO | $4,071 |
| Deseret Mutual | All Other | $4,071 |
| Deseret Mutual | Select | $4,071 |
| EMI Health | Mint | $4,071 |
| EMI Health | Network Care | $4,071 |
| EMI | Commercial | $4,071 |
| Franklin County | Commercial | $4,071 |
| Global Excel | Commercial | $4,071 |
| Health Utah | Commercial | $4,071 |
| Hygeia Corporation | Commercial | $4,071 |
| Intermountain Caregiver Plan | Med Network | $4,071 |
| Juniper Systems | Commercial | $4,071 |
| LW Miller | Commercial | $4,071 |
| Managed Care Admin | Commercial | $4,071 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.
All common services at Intermountain Health Bear River Valley Hospital