CT abdomen and pelvis with contrast at Adair County Memorial Hospital. CPT 74177.
What Adair County Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 2, 2026.
Outpatient / ER
$3,544cash price (self-pay)
$4,725list price
$910–$4,583range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellmark HMO | Wellmark HMO | $910 |
| Wellmark PPO - All Other Plans | Wellmark PPO - All Other Plans | $910 |
| UHC Va Ccn | UHC Va Ccn | $2,646 |
| UHC Mcr Adv | UHC Mcr Adv | $2,646 |
| Iowa Total Care-All Plans | Iowa Total Care-All Plans | $2,747 |
| Aetna Whole Health - All Plans | Aetna Whole Health - All Plans | $3,071 |
| Mahp-All Plans | Mahp-All Plans | $3,544 |
| UHC-All Other Plans | UHC-All Other Plans | $3,780 |
| Centivo-All Plans | Centivo-All Plans | $3,969 |
| Geha-All Plans | Geha-All Plans | $4,489 |
| Midlands Choice-All Plans | Midlands Choice-All Plans | $4,583 |
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