CT abdomen and pelvis with contrast at Veterans Memorial Hospital City Of Waukon Ia. CPT 74177.
What Veterans Memorial Hospital City Of Waukon Ia publishes for this service, straight from its standard-charges file, last updated May 11, 2026.
Outpatient / ER
$555cash price (self-pay)
$3,852list price
$65.00–$3,274range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellmark HMO - All Other Plans | Wellmark HMO - All Other Plans | $346 |
| Wellmark PPO | Wellmark PPO | $380 |
| Amerigroup Mcaid - All Other Plans | Amerigroup Mcaid - All Other Plan | $665 |
| Humana Mcr Adv | Humana Mcr Adv | $862 |
| Amerigroup Mcr Adv | Amerigroup Mcr Adv | $868 |
| Iowa Total Care Exchange | Iowa Total Care Exchange | $868 |
| Molina Mcr Adv | Molina Mcr Adv | $868 |
| Quartz Mcr Adv | Quartz Mcr Adv | $868 |
| Welmark Mcr Adv | Welmark Mcr Adv | $868 |
| Medica Comm - All Other Plans | Medica Comm - All Other Plans | $918 |
| Coventry/Aetna Mcr Adv | Coventry/Aetna Mcr Adv | $1,326 |
| Molina Mcaid - All Other Plans | Molina Mcaid - All Other Plans | $1,469 |
| Iowa Total Care Mcaid - All Other Plans | Iowa Total Care Mcaid - All | $1,469 |
| Quartz Comm - All Other Plans | Quartz Comm - All Other Plans | $1,477 |
| Humana Comm - All Other | Humana Comm - All Other | $1,478 |
| UHC Mcr Adv Ip/Op Only | UHC Mcr Adv Ip/Op Only | $1,656 |
| UHC Va Ip/Op Only | UHC Va Ip/Op Only | $1,656 |
| Iowa Total Care Mcr Adv | Iowa Total Care Mcr Adv | $1,656 |
| Medica Mcr Adv | Medica Mcr Adv | $1,656 |
| UHC Comm - All Other Plans | UHC Comm - All Other Plans | $3,274 |
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All common services at Veterans Memorial Hospital City Of Waukon Ia