CT abdomen and pelvis with contrast at UnityPoint Health - St. Luke's Hospital. CPT 74177.
What UnityPoint Health - St. Luke's Hospital 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–$2,541range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Advantage | $235 |
| Wellmark Blue Cross and Blue Shield | Medicare Advantage | $240 |
| Molina | Medicare Advantage | $240 |
| Humana | Medicare Advantage | $247 |
| United Healthcare | Medicare Advantage | $247 |
| Amerivantage | Medicare Advantage | $247 |
| Iowa Total Care | Managed Medicaid | $314 |
| Amerigroup | Managed Medicaid | $314 |
| United Healthcare | PPO | $340 |
| United Healthcare | HMO | $340 |
| Wellmark UHP Self-Funded | Commercial | $424 |
| Wellmark Blue Cross and Blue Shield | HMO | $424 |
| Wellmark Blue Cross and Blue Shield | PPO | $499 |
| Cigna/Midlands | Commercial | $510 |
| Health Partners Open Network | Commercial | $517 |
| Aetna | HMO | $611 |
| Aetna | PPO | $675 |
| Medica Exchange Inspire | Commercial | $1,549 |
| Medica Exchange Insure | Commercial | $1,739 |
Inpatient
$3,710cash price (self-pay)
$4,638list price
$2,541–$2,541range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna/Midlands | Commercial | $2,541 |
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All common services at UnityPoint Health - St. Luke's Hospital