CT abdomen and pelvis with contrast at MercyOne West Des Moines Medical Center. CPT 74177.
What MercyOne West Des Moines Medical Center publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$5,902cash price (self-pay)
$5,902list price
$329–$5,902range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicare Medical Associates Health Plans | Medical Associates Medicare | $330 |
| Medigold Medicare Advantage | Mercyone Health Plan Medicare Advantage | $330 |
| Molina Medicaid | Molina Medicaid | $333 |
| Blue Cross - Ia (Wellmark) Medicare Advantage | Wellmark Medicare Adva | $334 |
| Wellpoint Medicaid | Wellpoint Medicaid | $334 |
| Health Partners Medicare Advantage | Unitypoint Health Partners Medica | $340 |
| Wellpoint Medicare Advantage | Wellpoint Medicare Advantage | $344 |
| Blue Cross - Ne | Wellmark PPO | $356 |
| Blue Cross - Mo (Anthem) | Wellmark PPO | $356 |
| Blue Shield - Id (Regence) | Wellmark PPO | $356 |
| Blue Cross - Id | Wellmark PPO | $356 |
| Blue Cross - Ia (Wellmark) | Wellmark PPO | $356 |
| Blue Cross - Va (Carefirst) | Wellmark PPO | $356 |
| Blue Cross - IL | Wellmark PPO | $356 |
| Blue Distinction Transplant | Wellmark PPO | $356 |
| Blue Benefit Administrators Of Massachusetts | Wellmark PPO | $356 |
| Blue Cross - IL Alternate | Wellmark PPO | $356 |
| Blue Cross - Mn | Wellmark PPO | $356 |
| Blue Cross - Wi (Anthem) | Wellmark PPO | $356 |
| Amish Hospital Aid | Amish Hospital Aid | $448 |
| Oscar | Oscar | $479 |
| Centivo | Centivo | $486 |
| Ambetter | Ambetter Marketplace | $566 |
| Claimdoc | Claimdoc | $677 |
| Nova | Claimdoc | $677 |
| Geha | United Healthcare | $829 |
| United Healthcare | United Healthcare | $829 |
| Medical Associates | Medical Associates | $1,186 |
| Webtpa | Aetna | $2,048 |
| Medical Mutual | Aetna | $2,048 |
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All common services at MercyOne West Des Moines Medical Center