CT abdomen and pelvis with contrast at Mercy Hospital Carthage. CPT 74177.
What Mercy Hospital Carthage publishes for this service, straight from its standard-charges file, last updated June 9, 2026.
Outpatient / ER
$2,200cash price (self-pay)
$3,384list price
$189–$3,384range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Medicaid Contracted [320009] | Hb Cthg Ok Medicaid | $189 |
| Medicaid [20240] | Hb Cthg Ok Medicaid | $189 |
| Oklahoma Complete Health Medicaid Contracted [320485] | Hb Cthg Ok Med | $189 |
| Humana Medicaid Contracted [320486] | Hb Cthg Ok Medicaid | $189 |
| BCBS Medicaid Contracted [320046] | Hb Cthg Kancare Healthy Blue Medic | $207 |
| Kancare Contracted [320213] | Hb Cthg Kancare UHC Medicaid | $207 |
| Kancare Contracted [320213] | Hb Cthg Aetna Better Health (Kancare) | $207 |
| Kancare [20213] | Hb Cthg Kancare UHC Medicaid | $207 |
| Kancare [20213] | Hb Cthg Aetna Better Health (Kancare) | $207 |
| BCBS Medicaid Contracted [320046] | Hb Cthg Mo Care/Healthy Blue | $335 |
| BCBS Medicaid [20046] | Hb Cthg Mo Care/Healthy Blue | $335 |
| Nhc Advantage Medicare Contracted [320282] | Hb Jopl Nhc Advantage Mcr | $360 |
| Medicaid [20240] | Hb Cthg Mo Medicaid | $426 |
| Mo Medicaid Bh Carve Out [320315] | Hb Cthg Mo Medicaid | $426 |
| Home State Medicaid Contracted [320189] | Hb Cthg Home State | $465 |
| United Healthcare Medicaid Contracted [320397] | Hb Cthg UHC Mo Medica | $469 |
| Blue Cross And Blue Shield [20053] | Hb Cthg Anthem Traditional | $844 |
| Blue Cross And Blue Shield [20053] | Hb Cthg Anthem Pathways Exchange | $846 |
| Mc Anthem [20455] | Hb Cthg Anthem Alliance | $856 |
| Blue Cross And Blue Shield [20053] | Hb Cthg Anthem Alliance | $856 |
| Blue Cross And Blue Shield [20053] | Hb Cthg Anthem Blue Preferred | $895 |
| Mercy Mgd Behavioral Health Contracted [320259] | Hb Cthg Managed Medi | $930 |
| United Healthcare Medicare Advantage Contracted [320398] | Hb Cthg UHC | $930 |
| Qual Choice Contracted [320325] | Hb Cthg Managed Medicare | $930 |
| United Healthcare Contracted [320396] | Hb Cthg Medicare | $930 |
| Tricare Contracted [320380] | Hb Cthg Tricare | $933 |
| Mc Generic Anthem [20456] | Hb Cthg Anthem Blue Access/Access Choice | $1,180 |
| Mc Anthem [20455] | Hb Cthg Anthem Blue Access/Access Choice | $1,180 |
| Blue Cross And Blue Shield [20053] | Hb Cthg Anthem Blue Access/Access | $1,180 |
| Point C Contracted [320238] | Hb Jopl/Cthg Dec Joplin Supply Co | $1,184 |
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