CT abdomen and pelvis with contrast at Wesley Medical Center. CPT 74177.
What Wesley Medical Center publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$30,217cash price (self-pay)
$30,217list price
$207–$27,195range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare | MGMCD | $207 |
| HealthyBlue | MCD | $211 |
| Sunflower State Health Plan | MCD | $213 |
| Aetna Better Health | MCD | $215 |
| Amerigroup | MCD | $215 |
| First Health | WCOMP | $413 |
| Multiplan | BeechStreetWorkersComp | $431 |
| Multiplan | WorkersComp | $431 |
| BCBS | BlueChoice | $480 |
| BCBS | Cap | $480 |
| Aetna | LocalOpen | $564 |
| Aetna | NationalOpen | $645 |
| United | AllPayerAppendix | $828 |
| United | OptionsPPO | $4,321 |
| Health Partners of Kansas | CignaLocalPlusNetwork | $5,228 |
| WPPA | ProviderCareNetwork | $5,258 |
| WPPA | UnifiedHealth | $5,258 |
| WPPA | WPPAPrimeNetwork | $5,258 |
| Centene | HIX | $5,439 |
| Medical Associates Health Plan | COMM | $5,711 |
| Preferred Health Choices | COMM | $5,711 |
| Health Partners of Kansas | Non-LocalPlusandNon-ConnectCare | $7,131 |
| Spirit Aerosystems | COMMOON | $9,669 |
| Aetna | Spirit | $10,787 |
| First Health | PPO | $13,477 |
| United | GlobalBenefitPlan | $13,598 |
| Health Partners of Kansas | Humana | $15,109 |
| Triwest Healthcare Alliance | Tricare | $19,641 |
| Multiplan | COMMPPOPRIMARYNETWORK | $21,152 |
| Multiplan | COMMPPOCOMPLEMENTARYNETWORK | $25,684 |
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