CT abdomen and pelvis with contrast at UnityPoint Health - St. Lukes Downtown. CPT 74177.
What UnityPoint Health - St. Lukes Downtown publishes for this service, straight from its standard-charges file, last updated January 28, 2026.
Outpatient / ER
$162cash price (self-pay)
$680list price
$52.52–$1,190range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Nebraska Total Care | Managed Medicaid | $177 |
| Aetna | Medicare Advantage | $235 |
| Wellmark Blue Cross and Blue Shield | Medicare Advantage | $240 |
| Molina | Medicare Advantage | $240 |
| Amerivantage | Medicare Advantage | $247 |
| Humana | Medicare Advantage | $247 |
| United Healthcare | Medicare Advantage | $247 |
| Amerigroup | Managed Medicaid | $316 |
| Iowa Total Care | Managed Medicaid | $316 |
| United Healthcare | PPO | $340 |
| United Healthcare | HMO | $340 |
| Avera Health Plan | Commercial | $352 |
| Wellmark Blue Cross and Blue Shield | HMO | $424 |
| Wellmark UPH Self-Funded | Commercial | $424 |
| Wellmark Blue Cross and Blue Shield | PPO | $499 |
| Health Partners Open Network | Commercial | $500 |
| Cigna/Midlands | Commercial | $510 |
| Aetna | HMO | $629 |
| Aetna | PPO | $743 |
| Medica Exchange Inspire | Commercial | $945 |
| Medica Exchange Insure | Commercial | $1,058 |
Inpatient
$1,465cash price (self-pay)
$1,831list price
$1,152–$1,152range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna/Midlands | Commercial | $1,152 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.
All common services at UnityPoint Health - St. Lukes Downtown