CT scan of abdomen and pelvis without contrast at Good Samaritan Hospital

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

C CT ABD & PELVIS W/O CONTRAST

Puyallup, WA

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How this price compares nationally

Good Samaritan Hospital’s median price of $795 is 52% above the median hospital's median price ($524), higher than 62% of the 2,634 hospitals reporting CPT 74176. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 74176 at Good Samaritan Hospital

Negotiated rates from the hospital’s own file: 11 payers, 24 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Molina apple health fee schedule · outpatient	$224.34	$224.34	$224.34 – $224.34
2	UnitedHealthcare apple health fee schedule · outpatient	$242.29	$242.29	$242.29 – $242.29
3	Aetna medadvantage fee schedule · outpatient	$281.08	$281.08	$281.08 – $281.08
4	Regence medadvantage fee schedule · outpatient	$281.08	$281.08	$281.08 – $281.08
5	UnitedHealthcare medadvantage fee schedule · outpatient	$283.81	$283.81	$283.81 – $283.81
6	Molina medadvantage fee schedule · outpatient	$286.54	$286.54	$286.54 – $286.54
7	WellCare medadvantage fee schedule · outpatient	$286.54	$286.54	$286.54 – $286.54
8	Premera hmo fee schedule · outpatient	$437.46	$437.46	$437.46 – $437.46
9	Ambetter coordinated care exchange fee schedule · outpatient	$545.79	$545.79	$545.79 – $545.79
10	Regence blue high performance fee schedule · outpatient	$804.48	$804.48	$804.48 – $804.48
11	Regence mcc/ahn fee schedule · outpatient	$804.48	$804.48	$804.48 – $804.48
12	Regence realvalue fee schedule · outpatient	$827.46	$827.46	$827.46 – $827.46
13	Premera signature fee schedule · outpatient	$895.29	$895.29	$895.29 – $895.29
14	Premera prime fee schedule · outpatient	$915.44	$915.44	$915.44 – $915.44
15	Regence commercial fee schedule · outpatient	$919.40	$919.40	$919.40 – $919.40
16	Kaiser ppo fee schedule · outpatient	$1,081	$1,081	$1,081 – $1,081
17	Premera other commercial plans fee schedule · outpatient	$1,125	$1,125	$1,125 – $1,125
18	Aetna all commercial plans fee schedule · outpatient	$1,128	$1,128	$1,128 – $1,128
19	Cigna all commercial plans fee schedule · outpatient	$1,145	$1,145	$1,145 – $1,145
20	UnitedHealthcare all commercial plans fee schedule · outpatient	$1,218	$1,218	$1,218 – $1,218
21	First Health all commercial plans percent of total billed charges · outpatientfrom % of charges	$2,096	$2,096	$2,096 – $2,096
22	MultiPlan all commercial plans percent of total billed charges · outpatientfrom % of charges	$2,096	$2,096	$2,096 – $2,096
23	First Health all commercial plans percent of total billed charges · inpatientfrom % of charges	$2,620	$2,620	$2,620 – $2,620
24	MultiPlan all commercial plans percent of total billed charges · inpatientfrom % of charges	$2,620	$2,620	$2,620 – $2,620

Last updated: Aug 27, 2026

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