CT abdomen and pelvis with contrast at Mercy Hospital Boonville. CPT 74177.
What Mercy Hospital Boonville publishes for this service, straight from its standard-charges file, last updated June 8, 2026.
Outpatient / ER
$3,021cash price (self-pay)
$4,647list price
$189–$4,182range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Prominence Health Plan Medicare Advantage Contracted [320496] | Hb Bnv | $1,368 |
| Dept Of Veteran Affairs Contracted [320106] | Hb Bnvar Managed Medicar | $1,368 |
| Essence Healthcare Medicare Contracted [320122] | Hb Bnvar Managed Med | $1,368 |
| Globalhealth Contracted [320145] | Hb Bnvar Managed Medicare | $1,368 |
| BCBS Medicare Advantage Contracted [320047] | Hb Bnvar Managed Medicar | $1,368 |
| Aetna Medicare Advantage Contracted [320010] | Hb Bnvar Managed Medica | $1,368 |
| Cherokee Nation Health Serv Contracted [320066] | Hb Bnvar Managed Med | $1,368 |
| Valir Pace [20503] | Hb Bnvar Managed Medicare | $1,368 |
| Spina Bifida Hlthcare Benefit [20506] | Hb Bnvar Managed Medicare | $1,368 |
| Medical Associates Health [20444] | Hb Bnvar Managed Medicare | $1,368 |
| Wellfirst Health Mcr [20443] | Hb Bnvar Managed Medicare | $1,368 |
| Kindful Hospice [20434] | Hb Bnvar Managed Medicare | $1,368 |
| Pace Of The Ozarks [20518] | Hb Bnvar Managed Medicare | $1,368 |
| Jordan Valley Senior Care Pace [20515] | Hb Bnvar Managed Medicare | $1,368 |
| Cross Timbers Hospice [20098] | Hb Bnvar Managed Medicare | $1,368 |
| Blue Cross And Blue Shield [20053] | Hb Bnvar Managed Medicare | $1,368 |
| BCBS Medicare Advantage [20047] | Hb Bnvar Managed Medicare | $1,368 |
| Arkansas Community Care Medicare [20035] | Hb Bnvar Managed Medicare | $1,368 |
| Devoted Health Medicare Contracted [320500] | Hb Bnvar Devoted Health | $1,422 |
| Healthspring Medicare Advantage Contracted [320526] | Hb Bnvar Healths | $1,436 |
| Cigna Medicare Advantage Contracted [320072] | Hb Bnvar Healthspring 1 | $1,436 |
| Centivo Contracted [320505] | Hb Bnvar Centivo Mcr | $2,257 |
| MERCY INTERFACILITY [20513] | HB BNVAR Inter-Facility CCR New 6.1.25 | $2,268 |
| Aetna Contracted [320008] | Hb Wldar,Ozkar,Prsar,Bnvr Conventry/Aetna | $3,021 |
| Mercy Benefit Admin Contracted [320251] | Hb Wldar,Ozkar,Prsar,Bnvar,B | $3,950 |
| Mercy Benefit Admin Contracted [320251] | Hb Wldar,Ozkar,Prsar,Bnvar D | $3,950 |
| Show-Me Health Administrators Contracted [320483] | Hb Wldar,Ozkar,Prs | $3,950 |
| Insurance System Inc Contracted [320465] | Hb Bnvar Network Affiliatio | $3,950 |
| Ebms Contracted [320493] | Hb Wldar,Ozkar,Prsar,Bnvar,Bryv Crader | $3,950 |
| Reflect Health Contracted [320492] | Hb Wldar,Ozkar,Prsar,Bnvar,Bryv D | $3,950 |
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