CT abdomen and pelvis with contrast at Guttenberg Municipal Hospital. CPT 74177.
What Guttenberg Municipal Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$4,392cash price (self-pay)
$5,490list price
$2,854–$4,721range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| AETNA | Medicare | $2,855 |
| AETNA | Medicare HMO | $2,855 |
| AETNA | Medicare PPO | $2,855 |
| MEDICAL ASSOCIATES | Medicare | $2,855 |
| MOLINA | Medicare | $2,984 |
| Medical Associates | HMO | $4,118 |
| QUARTZ | Commercial | $4,392 |
| HEALTH CHOICES | Commercial | $4,721 |
Inpatient
$4,392cash price (self-pay)
$5,490list price
$3,678–$5,490range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellmark | HMO | $3,678 |
| Wellmark | PPO | $3,678 |
| HEALTH PARTNERS | Commercial | $3,843 |
| MIDLANDS CHOICE | Commercial | $3,843 |
| Medical Associates | HMO | $4,118 |
| AETNA | Medicare | $4,221 |
| AETNA | Medicare HMO | $4,221 |
| AETNA | Medicare PPO | $4,221 |
| MEDICAL ASSOCIATES | Medicare | $4,221 |
| UHC | Medicare | $4,221 |
| WELLMARK | Medicare | $4,221 |
| MOLINA | Medicare | $4,368 |
| QUARTZ | Commercial | $4,392 |
| HUMANA | Medicare | $4,432 |
| HEALTH CHOICES | Commercial | $4,721 |
| UHC | Commercial | $5,051 |
| IOWA TOTAL CARE | Medicaid | $5,490 |
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