CT abdomen and pelvis with contrast at Spencer Municipal Hospital. CPT 74177.
What Spencer Municipal Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$1,635cash price (self-pay)
$2,180list price
$336–$2,071range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellpoint | Medicare Advantage | $336 |
| Aetna | Medicare Advantage (HMO & PPO) | $336 |
| Wellmark | Medicare Advantage | $339 |
| Humana | Medicare Advantage (ALL) | $339 |
| Wellpoint | Medicaid | $342 |
| Iowa Total Care | Medicaid | $342 |
| Molina | Medicaid | $342 |
| UHC | Medicare Advantage | $437 |
| Wellmark | HMO | $834 |
| Wellmark | PPO | $916 |
| Health Partners | ALL | $1,744 |
| Aetna | Commercial HMO | $1,962 |
| UHC Commercial | ALL | $1,962 |
| Aetna | Commercial PPO | $2,071 |
| Humana | Commercial | $2,071 |
| Midlands Choice | All | $2,071 |
Inpatient
$1,635cash price (self-pay)
$2,180list price
$302–$2,071range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UHC | Medicare Advantage | $302 |
| Wellpoint | Medicare Advantage | $336 |
| Aetna | Medicare Advantage (HMO & PPO) | $336 |
| Wellmark | Medicare Advantage | $339 |
| Humana | Medicare Advantage (ALL) | $339 |
| Wellpoint | Medicaid | $342 |
| Iowa Total Care | Medicaid | $342 |
| Molina | Medicaid | $342 |
| Wellmark | HMO | $834 |
| Wellmark | PPO | $916 |
| Health Partners | ALL | $1,744 |
| Aetna | Commercial HMO | $1,962 |
| UHC Commercial | ALL | $1,962 |
| Aetna | Commercial PPO | $2,071 |
| Humana | Commercial | $2,071 |
| Midlands Choice | All | $2,071 |
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