CT abdomen and pelvis with contrast at Monroe County Hospital. CPT 74177.
What Monroe County Hospital publishes for this service, straight from its standard-charges file, last updated September 9, 2026.
Outpatient / ER
$3,214cash price (self-pay)
$5,356list price
$414–$5,195range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellmark HMO | Wellmark HMO | $414 |
| Wellmark PPO - All Other Plans | Wellmark PPO - All Other Plans | $445 |
| Tricare - All Plans | Tricare - All Plans | $2,250 |
| Mahp Mcare - All Plans | Mahp Mcare - All Plans | $2,250 |
| UHC Mcare | UHC Mcare | $2,250 |
| Va Ccn - All Plans | Va Ccn - All Plans | $2,250 |
| Amerigroup Mcare | Amerigroup Mcare | $2,272 |
| Humana Mcare - All Plans | Humana Mcare - All Plans | $2,272 |
| Wellmark Mcare | Wellmark Mcare | $2,272 |
| Aetna/Coventry Mcare | Aetna/Coventry Mcare | $2,295 |
| Aetna Mcaid | Aetna Mcaid | $2,464 |
| Iowa Total Care Mcaid - All Plans | Iowa Total Care Mcaid - All Plans | $2,513 |
| Molina Mcaid - All Plans | Molina Mcaid - All Plans | $2,550 |
| Amerigroup Mcaid - All Other Plans | Amerigroup Mcaid - All Other Plan | $2,612 |
| Centivo - All Plans | Centivo - All Plans | $3,374 |
| Midlands Choice - All Plans | Midlands Choice - All Plans | $3,749 |
| Preferred Hlth - All Plans | Preferred Hlth - All Plans | $4,017 |
| Geha - All Plans | Geha - All Plans | $4,285 |
| Multiplan - All Plans | Multiplan - All Plans | $4,820 |
| Aetna - All Other Plans | Aetna - All Other Plans | $5,035 |
| UHC All Payer - All Other Plans | UHC All Payer - All Other Plans | $5,088 |
| Integrated Hp - All Plans | Integrated Hp - All Plans | $5,195 |
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