CT abdomen and pelvis with contrast at Waverly Health Center. CPT 74177.
What Waverly Health Center publishes for this service, straight from its standard-charges file, last updated March 3, 2026.
Outpatient / ER
$2,471cash price (self-pay)
$4,751list price
$834–$4,276range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellmark HMO | Wellmark HMO | $834 |
| Wellmark PPO - All Other Plans | Wellmark PPO - All Other Plans | $916 |
| UHC Medicare | UHC Medicare | $1,805 |
| Choicecare Network - All Plans | Choicecare Network - All Plans | $1,823 |
| Medica Medicare Cost Plan-All Plans | Medica Medicare Cost Plan-All Pl | $2,043 |
| Midlands Choice Mcare | Midlands Choice Mcare | $2,043 |
| Hlth Partners Bridges Ntwrk | Hlth Partners Bridges Ntwrk | $3,302 |
| Hlth Partners Open Ntwrk - All Other Plans | Hlth Partners Open Ntwrk | $3,302 |
| UHC Comm-All Other Plans | UHC Comm-All Other Plans | $3,330 |
| Aetna-All Plans | Aetna-All Plans | $4,038 |
| Health Alliance-All Plans | Health Alliance-All Plans | $4,276 |
| Midlands Choice-All Other Plans | Midlands Choice-All Other Plans | $4,276 |
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