CT abdomen and pelvis with contrast at Providence Centralia Hospital. CPT 74177.
What Providence Centralia Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$1,322cash price (self-pay)
$2,543list price
$404–$3,032range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Kaiser | Medicare Managed Care Plan | $404 |
| Aetna | Medicare Managed Care - Hmo | $416 |
| Aetna | Medicare Managed Care - Ppo | $420 |
| Unitedhealthcare | Medicare Managed Care Plan | $432 |
| Blue Shield | Regence Medicare Managed Care Plan | $436 |
| Amerigroup | Medicare Managed Care Plan | $444 |
| Community Health Plan | Medicare Managed Care Plan | $646 |
| Molina | Exchange | $683 |
| Blue Cross | Premera Lifewise Exchange | $727 |
| Coordinated Care | Ambetter Exchange | $747 |
| Blue Shield | Regence Uniform Medical Plan Other Commercial Plan | $1,458 |
| Kaiser | All Commercial Plans | $1,511 |
| Cigna | All Commercial Plans | $1,796 |
| Blue Cross | Premera Heritage Signature All Commercial Plans | $2,266 |
| Blue Cross | Premera All Commercial Plans | $2,347 |
| First Choice | All Commercial Plans | $2,379 |
| Blue Shield | Regence All Commercial Plans | $2,820 |
| Aetna | All Commercial Plans | $3,032 |
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