CT abdomen and pelvis with contrast at Amberwell Hiawatha Association. CPT 74177.
What Amberwell Hiawatha Association publishes for this service, straight from its standard-charges file, last updated August 18, 2026.
Outpatient / ER
$3,613cash price (self-pay)
$3,613list price
$456–$6,018range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS Blue Choice | BCBS Blue Choice | $456 |
| BCBS Cap - All Other Plans | BCBS Cap - All Other Plans | $480 |
| Aetna Mcr Adv | Aetna Mcr Adv | $1,445 |
| Humana Mcr Adv - All Plans | Humana Mcr Adv - All Plans | $1,445 |
| UHC Mcr Adv | UHC Mcr Adv | $1,445 |
| Ambetter Comm - All Plans | Ambetter Comm - All Plans | $1,734 |
| Centrus Health Direct - All Plans | Centrus Health Direct - All Plans | $2,710 |
| Oscar - All Plans | Oscar - All Plans | $2,710 |
| Aetna Comm - All Other Plans | Aetna Comm - All Other Plans | $2,919 |
| UHC All Payer - All Other Plans | UHC All Payer - All Other Plans | $3,104 |
| Preferred Hlth - All Plans | Preferred Hlth - All Plans | $3,252 |
| Cigna/Hlth Partners - All Plans | Cigna/Hlth Partners - All Plans | $3,432 |
| Wppa Providrs Care - All Plans | Wppa Providrs Care - All Plans | $3,432 |
| Midlands Choice - All Plans | Midlands Choice - All Plans | $3,505 |
| Multiplan - All Plans | Multiplan - All Plans | $3,505 |
| Healthy Blue Mcaid - All Plans | Healthy Blue Mcaid - All Plans | $6,018 |
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