CT abdomen and pelvis with contrast at Prosser Memorial Hospital. CPT 74177.
What Prosser Memorial Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2025.
Outpatient / ER
$228cash price (self-pay)
$3,026list price
$48.49–$5,074range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Community Health Plan of Washington | All Medicaid and Exchange Plans | $625 |
| Coordinated Care | All Medicaid Plans | $625 |
| Kaiser Permanente | All Medicaid Plans | $625 |
| United Healthcare | All Medicaid Plans | $625 |
| Molina | All Medicaid Plans | $656 |
| Amerigroup | All Medicaid Plans | $662 |
| Community Health Plan of Washington | All Medicare Plans | $753 |
| Health Alliance Northwest | All Medicare Plans | $753 |
| Kaiser Permanente | All Medicare Plans | $753 |
| Molina | All Medicare & Marketplace Plans | $753 |
| United Healthcare | All Medicare Plans | $753 |
| Wellcare | All Medicare Plans | $753 |
| Humana | All Medicare Plans | $760 |
| Aetna | All Medicare Plans | $903 |
| Kaiser Permanente | All Commercial Plans | $904 |
| United Healthcare | All Commercial Plans | $1,355 |
| Ambetter | All Commercial Plans | $2,060 |
| Premera | All Commercial Plans | $2,313 |
| Asuris | PPO, POS Commercial Plans | $2,320 |
| Health Management Adminstrators | PPO, POS Commercial Plans | $2,320 |
| Regence | PPO, POS & RegenceCare Commercial Plans | $2,320 |
| Cigna | All Commercial Plans | $2,366 |
| Humana | All Commercial Plans | $2,444 |
| Aetna | All Commercial Plans | $2,445 |
| MultiPlan | All Commercial Plans | $2,572 |
| Asuris | All Other Commercial Plans | $2,602 |
| Health Management Adminstrators | All Other Commercial Plans | $2,602 |
| Regence | All Other Commercial Plans | $2,602 |
| First Choice | All Commercial Plans | $4,792 |
Inpatient
$228cash price (self-pay)
$3,026list price
$48.49–$5,131range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Community Health Plan of Washington | All Medicare Plans | $96.69 |
| Health Alliance Northwest | All Medicare Plans | $96.69 |
| Humana | All Medicare Plans | $96.69 |
| Kaiser Permanente | All Medicare Plans | $96.69 |
| Molina | All Medicare & Marketplace Plans | $96.69 |
| United Healthcare | All Medicare Plans | $96.69 |
| Wellcare | All Medicare Plans | $96.69 |
| Aetna | All Medicare Plans | $114 |
| Community Health Plan of Washington | All Medicaid and Exchange Plans | $1,166 |
| Coordinated Care | All Medicaid Plans | $1,166 |
| Kaiser Permanente | All Medicaid Plans | $1,166 |
| United Healthcare | All Medicaid Plans | $1,166 |
| Molina | All Medicaid Plans | $1,167 |
| Amerigroup | All Medicaid Plans | $1,236 |
| Ambetter | All Commercial Plans | $2,258 |
| Aetna | All Commercial Plans | $2,304 |
| Premera | All Commercial Plans | $2,313 |
| Asuris | PPO, POS Commercial Plans | $2,320 |
| Health Management Adminstrators | PPO, POS Commercial Plans | $2,320 |
| Regence | PPO, POS & RegenceCare Commercial Plans | $2,320 |
| Cigna | All Commercial Plans | $2,366 |
| Humana | All Commercial Plans | $2,444 |
| Asuris | All Other Commercial Plans | $2,602 |
| Health Management Adminstrators | All Other Commercial Plans | $2,602 |
| Regence | All Other Commercial Plans | $2,602 |
| Kaiser Permanente | All Commercial Plans | $2,657 |
| MultiPlan | All Commercial Plans | $2,713 |
| First Choice | All Commercial Plans | $4,792 |
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