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CT Scan of Abdomen and Pelvis, Without IV Contrast

Utah rates for HCPCS 74176

A detailed cross-sectional imaging exam of the abdomen and pelvis using X-rays, performed without contrast dye injected into a vein. A contrast drink may still be given to outline the bowel. It gives a clear picture of the organs, bones and other structures in this area and is used to investigate pain, injury, or suspected abnormalities.

Rates data updated July 2026.

Facilitymedian $107 · 10th–90th $93$5250%20%40%10th90th$107Professionalmedian $138 · 10th–90th $78$4270%10%10th90th$138$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
26 · Professional part
Typical Low
$93.33
Median
$107.15
Typical High
$524.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$245.47
Typical High
$1,174.90
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$77.62
Median
$107.15
Typical High
$338.84
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$102.33
Median
$141.25
Typical High
$645.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$263.03
Typical High
$416.87
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$74.13
Median
$100.00
Typical High
$173.78
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$87.10
Median
$144.54
Typical High
$263.03
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$263.03
Regence BlueShield
Setting
Facility
Modifier
26 · Professional part
Typical Low
$416.87
Median
$416.87
Typical High
$416.87
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$309.03
Typical High
$416.87
Regence BlueShield
Setting
Professional
Modifier
26 · Professional part
Typical Low
$114.82
Median
$134.90
Typical High
$190.55
Regence BlueShield
Setting
Professional
Modifier
TC · Technical part
Typical Low
$147.91
Median
$173.78
Typical High
$223.87
Select Health
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$288.40
Typical High
$309.03
Select Health
Setting
Professional
Modifier
26 · Professional part
Typical Low
$75.86
Median
$147.91
Typical High
$173.78
Select Health
Setting
Professional
Modifier
TC · Technical part
Typical Low
$95.50
Median
$128.82
Typical High
$158.49
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$165.96
Typical High
$323.59
United
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$194.98
Typical High
$398.11
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$70.79
Median
$77.62
Typical High
$147.91
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$97.72
Median
$120.23
Typical High
$245.47