CT abdomen and pelvis with contrast at MercyOne New Hampton Medical Center. CPT 74177.
What MercyOne New Hampton Medical Center publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$3,664cash price (self-pay)
$5,637list price
$9.09–$5,637range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross - Ia (Wellmark) Medicare Advantage | Wellmark Medicare Adva | $2,232 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $2,255 |
| Health Partners Medicare Advantage | Unitypoint Health Partners Medica | $2,277 |
| Wellpoint Medicare Advantage | Wellpoint Medicare Advantage | $2,300 |
| Medicare Medical Associates Health Plans | Medical Associates Medicare | $2,375 |
| United Healthcare Medicare | United Healthcare Medicare Advantage | $2,390 |
| Medigold Medicare Advantage | Mercyone Health Plan Medicare Advantage | $2,518 |
| Iowa Dept Of Public Health | Care For Yourself | $2,823 |
| Medical Associates | Medical Associates | $2,847 |
| Amish Hospital Aid | Amish Hospital Aid | $2,999 |
| Oscar | Oscar | $3,315 |
| Geha | United Healthcare | $3,382 |
| United Healthcare | United Healthcare | $3,382 |
| Ambetter | Ambetter Marketplace | $3,788 |
| Iowa Total Care | Iowa Total Care Medicaid | $3,852 |
| Molina Medicaid | Molina Medicaid | $3,909 |
| Wellpoint Medicaid | Wellpoint Medicaid | $3,928 |
| Claimdoc | Claimdoc | $4,532 |
| Nova | Claimdoc | $4,532 |
| Medical Mutual | Aetna | $5,327 |
| Trustmark Small Business Benefits | Aetna | $5,327 |
| 1199 National Benefit Fund | Aetna | $5,327 |
| First Health | Aetna | $5,327 |
| Meritain | Aetna | $5,327 |
| Luminare Health | Aetna | $5,327 |
| Aetna | Aetna | $5,327 |
| Asr Health Benefits | Aetna | $5,327 |
| Allied Benefit Systems | Aetna | $5,327 |
| Coventry | Aetna | $5,327 |
| Lucent Health | Aetna | $5,327 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.