CT abdomen and pelvis with contrast at Boone County Hospital. CPT 74177.
What Boone County Hospital publishes for this service, straight from its standard-charges file, last updated July 27, 2026.
Outpatient / ER
$2,624cash price (self-pay)
$3,280list price
$356–$3,116range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Tricare - All Plans | Tricare - All Plans | $356 |
| Wellmark HMO | Wellmark HMO | $882 |
| Wellmark PPO - All Other Plans | Wellmark PPO - All Other Plans | $969 |
| Choice Care Mcr Adv - All Plans | Choice Care Mcr Adv - All Plans | $1,345 |
| UHC Mcr Adv | UHC Mcr Adv | $1,345 |
| Humana Mcr Adv | Humana Mcr Adv | $1,345 |
| Iowa Hlth Adv - All Plans | Iowa Hlth Adv - All Plans | $1,345 |
| Mt Carmel Hp - All Plans | Mt Carmel Hp - All Plans | $1,345 |
| Va Ccn-All Plans | Va Ccn-All Plans | $1,345 |
| Amerigroup Mcr Adv - All Other Plans | Amerigroup Mcr Adv - All Other | $1,358 |
| Aetna Mcr Adv | Aetna Mcr Adv | $1,375 |
| Meridian Mcaid - All Plans | Meridian Mcaid - All Plans | $1,378 |
| Iowa Total Care Mcaid - All Plans | Iowa Total Care Mcaid - All Plans | $1,405 |
| Amerigroup Medicaid | Amerigroup Medicaid | $1,419 |
| UHC All Payer-All Other Plans | UHC All Payer-All Other Plans | $1,925 |
| Healthsmart Accell Network | Healthsmart Accell Network | $2,296 |
| Medical Associates Hp-All Plans | Medical Associates Hp-All Plans | $2,460 |
| Aetna Comm-All Other Plans | Aetna Comm-All Other Plans | $2,558 |
| Healthsmart PPO - All Other Plans | Healthsmart PPO - All Other Plans | $2,624 |
| Health Alliance-All Plans | Health Alliance-All Plans | $2,952 |
| Humana/Choice Care-All Other Plans | Humana/Choice Care-All Other Plan | $2,952 |
| Midlands Choice-All Plans | Midlands Choice-All Plans | $3,017 |
| Mutually Preferred-All Plans | Mutually Preferred-All Plans | $3,116 |
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