CT abdomen and pelvis with contrast at MercyOne North Iowa Medical Center. CPT 74177.
What MercyOne North Iowa Medical Center publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$4,437cash price (self-pay)
$6,826list price
$338–$6,826range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Iowa Total Care | Iowa Total Care Medicaid | $338 |
| Molina Medicaid | Molina Medicaid | $341 |
| Wellpoint Medicaid | Wellpoint Medicaid | $342 |
| Blue Cross - Md (Carefirst) | Wellmark PPO | $356 |
| Blue Cross - Me (Anthem) | Wellmark PPO | $356 |
| Blue Cross - Ms | Wellmark PPO | $356 |
| Blue Cross - MA | Wellmark PPO | $356 |
| Blue Cross - Nv (Anthem) | Wellmark PPO | $356 |
| Blue Cross - Mt | Wellmark PPO | $356 |
| Blue Cross - Nh (Anthem) | Wellmark PPO | $356 |
| Blue Shield - Id (Regence) | Wellmark PPO | $356 |
| Blue Cross - Id | Wellmark PPO | $356 |
| Blue Shield - Wa (Regence) | Wellmark PPO | $356 |
| Blue Cross - Wa (Premera) | Wellmark PPO | $356 |
| Blue Cross - Wy | Wellmark PPO | $356 |
| Blue Cross - Wv (Highmark) | Wellmark PPO | $356 |
| Blue Cross - Federal | Wellmark PPO | $356 |
| Blue Benefit Administrators Of Massachusetts | Wellmark PPO | $356 |
| Blue Cross - CA (Anthem) | Wellmark PPO | $356 |
| Blue Cross - Ar | Wellmark PPO | $356 |
| Blue Cross - Co (Anthem) | Wellmark PPO | $356 |
| Blue Shield - CA | Wellmark PPO | $356 |
| Blue Cross - Ct (Anthem) | Wellmark PPO | $356 |
| Blue Cross - De (Highmark) | Wellmark PPO | $356 |
| Blue Cross - Ga (Anthem) | Wellmark PPO | $356 |
| Blue Cross - FL | Wellmark PPO | $356 |
| Blue Cross - Dc (Carefirst) | Wellmark PPO | $356 |
| Blue Cross - Hi | Wellmark PPO | $356 |
| Blue Cross - IL Alternate | Wellmark PPO | $356 |
| Blue Cross - Va (Carefirst) | Wellmark PPO | $356 |
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