CT abdomen and pelvis with contrast at Mercy Family Medicine - Mansfield. CPT 74177.
What Mercy Family Medicine - Mansfield publishes for this service, straight from its standard-charges file, last updated June 12, 2026.
Outpatient / ER
$149cash price (self-pay)
$572list price
$105–$424range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare Contracted [320396] | Pb Stl UHC Core | $261 |
| Mercy Benefit Admin Contracted [320251] | Pb Stl Dec Employer Benefit | $291 |
| Administrative Payor [20005] | Pb Mercy Amish/Mennonite | $315 |
| Administrative Payor Contracted [320005] | Pb Mercy Amish/Mennonite | $315 |
Inpatient
$149cash price (self-pay)
$572list price
$105–$424range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare Contracted [320396] | Pb Stl UHC Core | $261 |
| Mercy Benefit Admin Contracted [320251] | Pb Stl Dec Employer Benefit | $291 |
| Administrative Payor [20005] | Pb Mercy Amish/Mennonite | $315 |
| Administrative Payor Contracted [320005] | Pb Mercy Amish/Mennonite | $315 |
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