CT abdomen and pelvis with contrast at Jefferson County Health Center. CPT 74177.
What Jefferson County Health Center publishes for this service, straight from its standard-charges file, last updated August 20, 2026.
Outpatient / ER
$1,502cash price (self-pay)
$3,309list price
$67.86–$3,309range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UHC Mcr Adv | UHC Mcr Adv | $602 |
| Tricare - All Plans | Tricare - All Plans | $665 |
| Iowa Total Care Comm - All Other Plans | Iowa Total Care Comm - All Ot | $679 |
| Iowa Total Care Mcr | Iowa Total Care Mcr | $679 |
| Humana Medicare-All Plans | Humana Medicare-All Plans | $680 |
| Molina Mcr Adv | Molina Mcr Adv | $683 |
| UHC Va Ccn | UHC Va Ccn | $685 |
| Amerigroup Mcr Adv | Amerigroup Mcr Adv | $685 |
| Aetna Mcr Adv | Aetna Mcr Adv | $851 |
| Coventry Medicare | Coventry Medicare | $851 |
| Wellmark HMO | Wellmark HMO | $902 |
| Wellmark Indemnity/PPO - All Other Plans | Wellmark Indemnity/PPO - Al | $993 |
| Midlands New Product | Midlands New Product | $1,451 |
| UHC All Payer-All Other Plans | UHC All Payer-All Other Plans | $1,534 |
| Midlands Choice-All Other Plans | Midlands Choice-All Other Plans | $1,583 |
| Molina Mcaid/Chip | Molina Mcaid/Chip | $1,864 |
| Iowa Total Care Mcaid | Iowa Total Care Mcaid | $1,864 |
| Amerigroup Medicaid - All Other Plans | Amerigroup Medicaid - All Othe | $1,876 |
| Coventry Commercial HMO | Coventry Commercial HMO | $2,813 |
| Aetna-All Other Plans | Aetna-All Other Plans | $2,978 |
| Coventry Commercial PPO - All Other Plans | Coventry Commercial PPO - | $2,978 |
| Molina Marketplace - All Other Plans | Molina Marketplace - All Other | $3,309 |
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