CT abdomen and pelvis with contrast at Mercy Hospital. CPT 74177.
What Mercy Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$188cash price (self-pay)
$188list price
$54.95–$1,295range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina Medicare Advantage | Medicare | $195 |
| Rx Allwin | Medicare | $195 |
| Carelon Health Medicaid | Carelon Medicaid | $262 |
| Wellcare Medicare | Wellcare Medicare Advantage | $369 |
| Connecticare Vip Medicare Advantage | Connecticare Medicare Advantage | $410 |
| Tufts Medicare Advantage | Tufts Medicare Advantage | $410 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $410 |
| BCBS Medicare Advantage Generic | BCBS Medicare Advantage | $410 |
| Medigold Medicare Advantage | Mount Carmel Health Plan | $410 |
| Health New England Medicare Advantage | Health New England Medicare Ad | $414 |
| Carepartners Of Connecticut Medicare Advantage | Carepartners Medicare | $418 |
| United Healthcare Medicare | United Healthcare Medicare Advantage | $418 |
| Commonwealth Care Alliance Medicare | Commonwealth Care Alliance Medic | $418 |
| Cca Senior Care Options | Commonwealth Care Alliance Medicare Adv | $418 |
| Fallon Health Medicare Advantage | Fallon Health Medicare Advantage | $418 |
| Mass General Brigham Mcr Adv | Mass General Brigham Health Medicare Ad | $418 |
| Prime Health Services Medicare Advantage | Prime Health Medicare Advan | $426 |
| Molina Medicare Advantage | Senior Whole Health | $430 |
| Fallon Health Medicare Advantage | Fallon Navicare Medicare Advantage | $431 |
| Meritain | Aetna | $434 |
| Aetna | Aetna | $434 |
| Blue Cross - MA | BCBS HMO | $441 |
| Kaiser Domestic | BCBS PPO | $441 |
| Blue Cross - Nj (Horizon) | BCBS PPO | $441 |
| Blue Cross - Nh (Anthem) | BCBS PPO | $441 |
| Blue Cross - Nv (Anthem) | BCBS PPO | $441 |
| Blue Cross - Mt | BCBS PPO | $441 |
| Blue Cross - Ms | BCBS PPO | $441 |
| Connecticare | Connecticare Cbi | $539 |
| Fallon Health | Fallon Community Health Plan | $544 |
Inpatient
$213cash price (self-pay)
$213list price
$54.95–$802range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid - Mo | Medicaid | $157 |
| Medicaid - Mn | Medicaid | $157 |
| Medicaid - Tn | Medicaid | $157 |
| Medicaid - Sd | Medicaid | $157 |
| Medicaid - Ri | Medicaid | $157 |
| Medicaid - Sc | Medicaid | $157 |
| Medicaid - Pa | Medicaid | $157 |
| Medicaid - Oh | Medicaid | $157 |
| Cenpatico | Medicaid | $157 |
| Blue Cross - IL Medicaid Advantage | Medicaid | $157 |
| Medicaid MA Qmb | Medicaid | $157 |
| Keystone First Chip | Medicaid | $157 |
| Upper Peninsula Health Plan (Uphp) Medicaid | Medicaid | $157 |
| Cigna Medicaid Advantage | Medicaid | $157 |
| Wellcare Medicaid | Medicaid | $157 |
| Molina Medicaid | Medicaid | $157 |
| Nextlevel Health | Medicaid | $157 |
| Meridian Medicaid | Medicaid | $157 |
| Family Health Network | Medicaid | $157 |
| Positive Healthcare Partners Medicaid | Medicaid | $157 |
| Hap Medicaid | Medicaid | $157 |
| Medicaid - Ok | Medicaid | $157 |
| Medicaid - Nc | Medicaid | $157 |
| Medicaid - Or | Medicaid | $157 |
| Rx Allwin | Medicare | $195 |
| Molina Medicare Advantage | Medicare | $195 |
| Pacificsource Health Plans Medicare Advantage | Medicare | $195 |
| Coventry Medicare Advantage | Medicare | $195 |
| Aetna Medicare Transplant | Medicare | $195 |
| Provider Partners Health Plan Of Indiana | Medicare | $195 |
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