CT abdomen and pelvis with contrast at MercyOne Waterloo Medical Center. CPT 74177.
What MercyOne Waterloo Medical Center publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$3,554cash price (self-pay)
$5,467list price
$115–$5,467range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Medicare Advantage | Aetna Medicare Advantage | $329 |
| Iowa Total Care | Iowa Total Care Medicaid | $334 |
| Molina Medicaid | Molina Medicaid | $338 |
| Wellpoint Medicaid | Wellpoint Medicaid | $339 |
| Blue Cross - Ia (Wellmark) | Wellmark HMO | $356 |
| Blue Cross - Ia (Wellmark) | Wellmark PPO | $356 |
| Kaiser Domestic | Wellmark PPO | $356 |
| Blue Cross - Pa (Capital) | Wellmark PPO | $356 |
| Blue Cross - Ok | Wellmark PPO | $356 |
| Blue Cross - Or (Regence) | Wellmark PPO | $356 |
| Blue Shield - NY Highmark Northeastern | Wellmark PPO | $356 |
| Blue Cross - Nc | Wellmark PPO | $356 |
| Blue Cross - Dc (Carefirst) | Wellmark PPO | $356 |
| Blue Cross - FL | Wellmark PPO | $356 |
| Blue Cross - Ga (Anthem) | Wellmark PPO | $356 |
| Blue Cross - Hi | Wellmark PPO | $356 |
| Blue Cross - Ak (Premera) | Wellmark PPO | $356 |
| Blue Cross - Az | Wellmark PPO | $356 |
| Blue Cross - Ar | Wellmark PPO | $356 |
| Blue Cross - CA (Anthem) | Wellmark PPO | $356 |
| Blue Shield - CA | Wellmark PPO | $356 |
| Blue Cross - Ks | Wellmark PPO | $356 |
| Blue Cross - Mo (Anthem) | Wellmark PPO | $356 |
| Blue Cross - Nd | Wellmark PPO | $356 |
| Blue Cross - Ne | Wellmark PPO | $356 |
| Blue Cross - Oh (Anthem) | Wellmark PPO | $356 |
| Blue Cross - IL Alternate | Wellmark PPO | $356 |
| Blue Cross - Mn | Wellmark PPO | $356 |
| Blue Benefit Administrators Of Massachusetts | Wellmark PPO | $356 |
| Blue Cross - NY (Excellus) | Wellmark PPO | $356 |
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