CT abdomen and pelvis with contrast at Jefferson County Public Hospital District No 2. CPT 74177.
What Jefferson County Public Hospital District No 2 publishes for this service, straight from its standard-charges file, last updated August 6, 2026.
Outpatient / ER
$212cash price (self-pay)
$4,988list price
$84.84–$4,489range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Chpw Mcaid | Chpw Mcaid | $874 |
| Molina Mcaid | Molina Mcaid | $891 |
| Healthnet Tricare-All Plans | Healthnet Tricare-All Plans | $915 |
| Amerigroup Mcaid-All Plans | Amerigroup Mcaid-All Plans | $917 |
| Molina Mcr Adv | Molina Mcr Adv | $922 |
| Aetna Mcr Adv | Aetna Mcr Adv | $922 |
| Regence Medicare | Regence Medicare | $939 |
| Chpw Mcr Adv | Chpw Mcr Adv | $989 |
| Molina Marketplace-All Other Plans | Molina Marketplace-All Other Plan | $1,144 |
| Coord Care Mcaid Ip/Op Only | Coord Care Mcaid Ip/Op Only | $1,669 |
| Regence-All Other Plans | Regence-All Other Plans | $1,970 |
| Chpw Commercial-All Other Plans | Chpw Commercial-All Other Plans | $2,184 |
| Premera-All Plans | Premera-All Plans | $2,233 |
| Aetna-All Other Plans | Aetna-All Other Plans | $2,293 |
| Coord Care Comm/Exchge-All Other Plans | Coord Care Comm/Exchge-All Ot | $2,312 |
| Cigna-All Plans | Cigna-All Plans | $2,364 |
| UHC Comm/Marketplace-All Plans | UHC Comm/Marketplace-All Plans | $2,793 |
| Coord Care Cascade Ip/Op Only | Coord Care Cascade Ip/Op Only | $4,489 |
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All common services at Jefferson County Public Hospital District No 2