CT abdomen and pelvis with contrast at Mercy Hospital South. CPT 74177.
What Mercy Hospital South publishes for this service, straight from its standard-charges file, last updated June 10, 2026.
Outpatient / ER
$2,040cash price (self-pay)
$3,139list price
$204–$3,139range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina Healthcare Medicaid Contracted [320265] | Hb Wash Jefn Linc Sam | $204 |
| Cherokee Nation Health Serv Contracted [320066] | Hb Samc Medicare And | $343 |
| BCBS Medicare Advantage Contracted [320047] | Hb Samc Medicare And 100 | $343 |
| Aetna Medicare Advantage Contracted [320010] | Hb Samc Aetna And Coven | $343 |
| Aetna Medicare Advantage Contracted [320010] | Hb Samc Medicare And 10 | $343 |
| Dept Of Veteran Affairs Contracted [320106] | Hb Samc Medicare And 100 | $343 |
| Globalhealth Contracted [320145] | Hb Samc Medicare And 100% Managed M | $343 |
| Mercy Hospice Okc [20252] | Hb Samc Medicare And 100% Managed Medicare | $343 |
| Kindful Hospice [20434] | Hb Samc Medicare And 100% Managed Medicare | $343 |
| Elara Caring Aspire Hospice [20433] | Hb Samc Medicare And 100% Manage | $343 |
| Halo Hcr Inc Hospice [20432] | Hb Samc Medicare And 100% Managed Medic | $343 |
| Cross Timbers Hospice [20098] | Hb Samc Medicare And 100% Managed Medi | $343 |
| Generic Medicare Managed Care [20137] | Hb Samc Medicare And 100% Mana | $343 |
| Medicare [20244] | Hb Samc Medicare And 100% Managed Medicare | $343 |
| Humana Medicare Advantage [20194] | Hb Samc Medicare And 100% Managed | $343 |
| American Health Advantage Of Mo Mcr [10473] | Hb Samc Medicare And 100 | $343 |
| Qual Choice Contracted [320325] | Hb Samc Medicare And 100% Managed Me | $343 |
| United Healthcare Contracted [320396] | Hb Samc Medicare And 100% Mana | $343 |
| Tricare Contracted [320380] | Hb Samc Tricare - Healthnet West | $343 |
| Elara Caring Aspire Hospice Contracted [320433] | Hb Samc Medicare And | $343 |
| Kindful Hospice Contracted [320434] | Hb Samc Medicare And 100% Manage | $343 |
| Wellcare Medicare Advantage Contracted [320421] | Hb Samc Medicare And | $343 |
| Halo Hcr Inc Hospice Contracted [320432] | Hb Samc Medicare And 100% M | $343 |
| United Healthcare Medicare Advantage Contracted [320398] | Hb Samc Med | $343 |
| Longevity Health Plan Medicare Contracted [320225] | Hb Samc Medicare | $343 |
| Humana Medicare Advantage Contracted [320194] | Hb Samc Humana Medicar | $343 |
| Nhc Advantage Medicare Contracted [320282] | Hb Samc Medicare And 100% | $343 |
| Pace Of The Ozarks Contracted [320518] | Hb Samc Medicare And 100% Man | $343 |
| Medica Medicare Advantage Contracted [320477] | Hb Samc Medicare And 1 | $343 |
| Prominence Health Plan Medicare Advantage Contracted [320496] | Hb Sam | $343 |
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