CT abdomen and pelvis with contrast at Astria Toppenish Hospital. CPT 74177.
What Astria Toppenish Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$5,584cash price (self-pay)
$8,590list price
$211–$8,590range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid | Medicaid | $211 |
| Amerigroup_medicaid | Medicaid | $285 |
| Coordinated_care_ambetter_exchange | Medicare | $285 |
| Kaiser_medicaid | Medicaid | $285 |
| UHC | Commercial | $285 |
| Va | Medicare | $285 |
| Molina | Medicaid | $290 |
| Chpw_medicare | Medicare | $293 |
| Coordinated_care_medicaid | Medicaid | $358 |
| Molina_exchange | Medicaid | $370 |
| Li | Commercial | $391 |
| Aetna_medicare | Medicare | $392 |
| Cigna | Commercial | $392 |
| Health_alliance_medicare_advantage | Medicare | $392 |
| Hma_ihs_medicare | Medicare | $392 |
| Humana_medicare | Medicare | $392 |
| Kaiser_medicare | Medicare | $392 |
| Medicare | Medicare | $392 |
| Molina_medicare | Medicare | $392 |
| Premera_medicare_advantage | Medicare | $392 |
| Regence_medicare | Medicare | $392 |
| Uhc_medicaid | Medicaid | $392 |
| Tricare | Medicare | $392 |
| Zenith | Commercial | $396 |
| Chpw_medicaid | Medicaid | $686 |
| Kaiser | Commercial | $1,495 |
| Regence | Commercial | $2,912 |
| Premera | Commercial | $3,238 |
| Premera_affordable_care | Commercial | $3,238 |
| Bcchp | Commercial | $4,695 |
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