CT abdomen and pelvis with contrast at Providence St Peter Hospital. CPT 74177.
What Providence St Peter 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
$341–$2,138range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Kaiser | Medicare Managed Care Plan | $401 |
| Aetna | Gatekeeper Medicare Managed Care - Hmo | $413 |
| Aetna | Non-Gatekeeper Medicare Managed Care - Ppo | $417 |
| Unitedhealthcare | Medicare Managed Care Plan | $429 |
| Blue Shield | Regence Medicare Managed Care Plan | $433 |
| Humana | Medicare Managed Care Plan | $441 |
| Community Health Plan | Medicare Managed Care Plan | $642 |
| Molina | Exchange | $678 |
| Blue Cross | Premera Lifewise Exchange | $722 |
| Unitedhealthcare | Navigate Other Commercial Plan | $735 |
| Coordinated Care | Ambetter Exchange | $742 |
| Unitedhealthcare | Aco Tiered Other Commercial Plan | $912 |
| Blue Shield | Regence Uniform Medical Plan Other Commercial Plan | $1,006 |
| Blue Cross | Premera Heritage Signature Other Commercial Plan | $1,179 |
| Blue Cross | Premera All Commercial Plans | $1,205 |
| Kaiser | All Commercial Plans | $1,277 |
| Providence Health Plan | Signature/Choice Network Other Commercial Pla | $1,310 |
| Blue Shield | Regence All Commercial Plans | $1,359 |
| Cigna | All Commercial Plans | $1,397 |
| Unitedhealthcare | All Commercial Plans | $1,568 |
| Aetna | All Commercial Plans | $1,751 |
| First Choice | All Commercial Plans | $2,138 |
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