CT abdomen and pelvis with contrast at UnityPoint Health - Grinnell Regional Medical Center. CPT 74177.
What UnityPoint Health - Grinnell Regional Medical Center publishes for this service, straight from its standard-charges file, last updated January 28, 2026.
Outpatient / ER
$162cash price (self-pay)
$680list price
$79.84–$3,948range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Advantage | $235 |
| Molina | Medicare Advantage | $240 |
| Wellmark Blue Cross and Blue Shield | Medicare Advantage | $240 |
| Amerivantage | Medicare Advantage | $247 |
| Humana | Medicare Advantage | $247 |
| United Healthcare | Medicare Advantage | $247 |
| United Healthcare | HMO | $340 |
| United Healthcare | PPO | $340 |
| Amerigroup | Managed Medicaid | $355 |
| Iowa Total Care | Managed Medicaid | $355 |
| Wellmark Blue Cross and Blue Shield | HMO | $424 |
| Wellmark UPH Self-Funded | Commercial | $424 |
| Wellmark Blue Cross and Blue Shield | PPO | $499 |
| Cigna/Midlands | Commercial | $510 |
| Health Partners Open Network | Commercial | $559 |
| Aetna | HMO | $629 |
| Aetna | PPO | $743 |
| Medica Exchange Inspire | Commercial | $1,481 |
| Medica Exchange Insure | Commercial | $1,658 |
Inpatient
$3,290cash price (self-pay)
$4,113list price
$2,567–$3,948range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna/Midlands | Commercial | $2,567 |
| United Healthcare | HMO | $2,994 |
| United Healthcare | PPO | $2,994 |
| Aetna | PPO | $3,948 |
| Aetna | HMO | $3,948 |
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All common services at UnityPoint Health - Grinnell Regional Medical Center