CT abdomen and pelvis with contrast at Mountain West Medical Center. CPT 74177.
What Mountain West Medical Center publishes for this service, straight from its standard-charges file, last updated September 17, 2026.
Outpatient / ER
$3,027cash price (self-pay)
$5,045list price
$353–$4,642range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Select Health Mcr Adv | Select Health Mcr Adv | $353 |
| Regence BCBS Mcr Adv | Regence BCBS Mcr Adv | $353 |
| Molina Medicare-All Plans | Molina Medicare-All Plans | $442 |
| Aetna -All Plans | Aetna -All Plans | $1,131 |
| Regence BCBS-All Other Plans | Regence BCBS-All Other Plans | $1,563 |
| U Of Ut-All Plans | U Of Ut-All Plans | $3,280 |
| Wise/Motivhealth-All Plans | Wise/Motivhealth-All Plans | $3,280 |
| Cigna-All Plans | Cigna-All Plans | $3,577 |
| Dmba-All Plans | Dmba-All Plans | $3,633 |
| Pehp-All Plans | Pehp-All Plans | $3,784 |
| Select Health-All Other Plans | Select Health-All Other Plans | $3,784 |
| UHC-All Plans | UHC-All Plans | $3,885 |
| Multiplan Primary Network-All Other Plans | Multiplan Primary Network- | $3,986 |
| Emi-All Plans | Emi-All Plans | $4,289 |
| Humana-All Plans | Humana-All Plans | $4,289 |
| Multiplan Complimentary Network | Multiplan Complimentary Network | $4,642 |
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