CT abdomen and pelvis with contrast at Iowa Specialty Hospital Belmond. CPT 74177.
What Iowa Specialty Hospital Belmond publishes for this service, straight from its standard-charges file, last updated April 22, 2026.
Outpatient / ER
$212cash price (self-pay)
$2,642list price
$79.83–$4,782range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellmark HMO | Wellmark HMO | $521 |
| Wellmark PPO-All Other Plans | Wellmark PPO-All Other Plans | $575 |
| Tricare-All Plans | Tricare-All Plans | $829 |
| Aetna/Coventry Mcr Adv | Aetna/Coventry Mcr Adv | $829 |
| Triwest Va Choice And Pc3-All Plans | Triwest Va Choice And Pc3-All Pl | $829 |
| UHC Mcr Adv | UHC Mcr Adv | $829 |
| Healthscope Stellar - All Plans | Healthscope Stellar - All Plans | $1,367 |
| Auxiant Clarion Schools-All Plans | Auxiant Clarion Schools-All Plans | $1,717 |
| Health Partners Prestage | Health Partners Prestage | $1,982 |
| Health Partners Ish-All Other Plans | Health Partners Ish-All Other Pl | $2,049 |
| UHC Comm-All Other Plans | UHC Comm-All Other Plans | $2,273 |
| Aetna/Coventry HMO | Aetna/Coventry HMO | $2,337 |
| Aetna/Coventry PPO-All Other Plans | Aetna/Coventry PPO-All Other Plan | $2,386 |
| Cigna-All Plans | Cigna-All Plans | $2,727 |
| Midlands Choice-All Plans | Midlands Choice-All Plans | $2,727 |
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