CT abdomen and pelvis with contrast at St. Michael Medical Center. CPT 74177.
What St. Michael Medical Center publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$5,605cash price (self-pay)
$12,700list price
$416–$11,430range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CHPW | Medicare|All Plans | $416 |
| Kaiser | Medicare|All Plans | $416 |
| Optum | Medicare|All Plans | $420 |
| Aetna | Medicare|All Plans | $429 |
| BCBS - Premera | Medicare|All Plans | $429 |
| BCBS - Regence | Medicare|All Plans | $429 |
| Humana | Medicare|All Plans | $445 |
| Molina | Medicare|All Plans | $450 |
| United | Medicare|All Plans | $450 |
| Wellcare | Medicare|All Plans | $455 |
| Sound Family Medicine | Commercial|All Plans | $832 |
| Molina | Commercial|Marketplace Exchange | $957 |
| Coordinated Care | Commercial|Ambetter Exchange | $974 |
| Uniform Medical Plan | Commercial|All Plans | $1,064 |
| Cigna | Commercial|All Plans | $1,101 |
| BCBS - Regence | Commercial|All Plans | $1,223 |
| Kaiser | Commercial|All Plans | $1,441 |
| BCBS - Premera | Commercial|LifeWise Primary Exchange | $1,510 |
| BCBS - Premera | Commercial|All Other Plans | $1,669 |
| Aetna | Commercial|AWH | $8,636 |
| Aetna | Commercial|Sound Health | $9,144 |
| First Choice | Commercial|All Plans | $9,271 |
| Aetna | Commercial|All Other Plans | $10,160 |
| Aetna | Commercial|WEA | $10,160 |
| United | Commercial|All Other Plans | $10,414 |
| United | Commercial|Cascade Care | $10,414 |
| Aetna | Commercial|Rental | $11,176 |
| MultiPlan | Commercial|All Plans | $11,430 |
Inpatient
$5,605cash price (self-pay)
$12,700list price
$8,001–$11,430range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | Commercial|All Plans | $8,001 |
| Aetna | Commercial|AWH | $8,636 |
| Aetna | Commercial|Sound Health | $9,144 |
| First Choice | Commercial|All Plans | $9,271 |
| Aetna | Commercial|All Other Plans | $10,160 |
| Aetna | Commercial|WEA | $10,160 |
| United | Commercial|All Other Plans | $10,795 |
| United | Commercial|Cascade Care | $10,795 |
| Aetna | Commercial|Rental | $11,176 |
| MultiPlan | Commercial|All Plans | $11,430 |
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