CT abdomen and pelvis with contrast at Summit Pacific Medical Center. CPT 74177.
What Summit Pacific Medical Center publishes for this service, straight from its standard-charges file, last updated August 31, 2026.
Outpatient / ER
$3,563cash price (self-pay)
$6,598list price
$1,524–$5,938range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Chpw Basic Hp | Chpw Basic Hp | $1,524 |
| Chpw Chip | Chpw Chip | $1,524 |
| Chpw Healthy Options | Chpw Healthy Options | $1,524 |
| Regence Bs Mcr Adv - All Plans | Regence Bs Mcr Adv - All Plans | $1,650 |
| Triwest - All Plans | Triwest - All Plans | $1,650 |
| Amerigroup Mcaid - All Plans | Amerigroup Mcaid - All Plans | $1,677 |
| Chpw Mcr Adv | Chpw Mcr Adv | $1,699 |
| Wellcare Mcr Adv - All Plans | Wellcare Mcr Adv - All Plans | $1,748 |
| Chpw Pebb - All Other Plans | Chpw Pebb - All Other Plans | $4,619 |
| Cigna - All Plans | Cigna - All Plans | $5,278 |
| First Choice - All Plans | First Choice - All Plans | $5,278 |
| UHC All Payer - All Plans | UHC All Payer - All Plans | $5,608 |
| Aetna Comm - All Plans | Aetna Comm - All Plans | $5,938 |
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