CT abdomen and pelvis with contrast at Lone Peak Hospital. CPT 74177.
What Lone Peak Hospital publishes for this service, straight from its standard-charges file, last updated October 1, 2024.
Outpatient / ER
$8,489cash price (self-pay)
$8,489list price
$443–$2,626range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | IFPLP | $443 |
| Cigna | OAPNBN | $500 |
| Regence | FocalPointPlus | $519 |
| Cigna | Exclusive | $575 |
| Regence | FocalPoint | $578 |
| Regence | Individual | $689 |
| Regence | Preferred | $689 |
| Regence | RealValue | $689 |
| Regence | Participating | $847 |
| Regence | Traditional | $847 |
| Aetna | PeakPreference | $1,580 |
| Aetna | StandardNetwork | $2,071 |
| Aetna | AetnaSignatureAdministrators | $2,558 |
| Aetna | UtahConnectedNetwork | $2,626 |
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