CT abdomen and pelvis with contrast at Mercy Pediatrics - Carthage. CPT 74177.
What Mercy Pediatrics - Carthage publishes for this service, straight from its standard-charges file, last updated June 12, 2026.
Outpatient / ER
$148cash price (self-pay)
$410list price
$56.87–$607range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| AETNA MEDICAID [20009] | PB OK,AR,SGF,JOPL OK MCD ADVANTAGE Plans | $178 |
| Aetna Medicaid Contracted [320009] | Pb Ok,Ar,Sgf,Jopl Ok Mcd Advantag | $178 |
| HUMANA MEDICAID [20486] | PB OK,AR,SGF,JOPL OK MCD ADVANTAGE Plans | $178 |
| Humana Medicaid Contracted [320486] | Pb Ok,Ar,Sgf,Jopl Ok Mcd Advanta | $178 |
| Medicaid [20240] | Pb Sprg/Jopl/Cape/Stod Medicaid Mo | $179 |
| Aetna Medicare Advantage [20010] | Pb Sprg/Jopl Aetna Medicare-Missou | $188 |
| Aetna Medicare Advantage [20010] | Pb Sprg/Jopl/Cape/Stod Medicare Mo | $188 |
| Aetna Medicare Advantage Contracted [320010] | Pb Sprg/Jopl Aetna Med | $188 |
| BCBS Medicare Advantage Contracted [320047] | Pb Sprg/Jopl Blue Cross | $188 |
| Humana Medicare Advantage Contracted [320194] | Pb Sprg/Jopl/Ks Humana | $188 |
| Medicare [20244] | Pb Sprg/Jopl/Cape/Stod Medicare Mo 99 | $188 |
| Devoted Health Medicare Contracted [320500] | Pb Sprg-Jopl Devoted Hea | $195 |
| Medicaid [20240] | Pb Sprg/Jopl Medicaid Arkansas | $206 |
| Humana Contracted [320193] | Pb Jopl Humana/Ppox | $225 |
| Administrative Payor [20005] | Pb Mercy Amish/Mennonite | $226 |
| Administrative Payor Contracted [320005] | Pb Mercy Amish/Mennonite | $226 |
| Boon Chapman Contracted [320055] | Pb Jopl Krey Distributing | $226 |
| Healthsmart Preferred Care Contracted [320184] | Pb Sprg/Jopl Arvest B | $226 |
| BCBS Medicaid [20046] | Pb Sprg/Jopl Missouri Care/Healthy Blue | $236 |
| BCBS Medicaid Contracted [320046] | Pb Sprg/Jopl Missouri Care/Healthy | $236 |
| Blue Cross And Blue Shield [20053] | Pb Sprg/Jopl Anthem Alliance Outs | $238 |
| Mc Anthem [20455] | Pb Sprg/Jopl Anthem Alliance Outside Greene County | $238 |
| Blue Cross And Blue Shield [20053] | Pb Sprg Jopl Anthem Pathways X (E | $245 |
| Blue Cross And Blue Shield [20053] | Pb Sprg Jopl Anthem Blue Preferre | $247 |
| United Healthcare Contracted [320396] | Pb Sprg/Jopl United Healthcare | $249 |
| Blue Cross And Blue Shield [20053] | Pb Sprg Jopl Anthem Blue Access | $252 |
| Mc Generic Anthem [20456] | Pb Sprg Jopl Anthem Blue Access | $252 |
| Healthlink Contracted [320179] | Pb Sprg/Jopl Healthlink | $277 |
| Auxiant Contracted [320462] | Pb Sprg-Jopl Buchheit Dec | $283 |
| Mercy Benefit Admin [20251] | Pb Sprg-Jopl Bartel Comminications Dec | $283 |
Inpatient
$148cash price (self-pay)
$410list price
$56.87–$607range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| AETNA MEDICAID [20009] | PB OK,AR,SGF,JOPL OK MCD ADVANTAGE Plans | $178 |
| Aetna Medicaid Contracted [320009] | Pb Ok,Ar,Sgf,Jopl Ok Mcd Advantag | $178 |
| HUMANA MEDICAID [20486] | PB OK,AR,SGF,JOPL OK MCD ADVANTAGE Plans | $178 |
| Humana Medicaid Contracted [320486] | Pb Ok,Ar,Sgf,Jopl Ok Mcd Advanta | $178 |
| Medicaid [20240] | Pb Sprg/Jopl/Cape/Stod Medicaid Mo | $179 |
| Aetna Medicare Advantage [20010] | Pb Sprg/Jopl Aetna Medicare-Missou | $188 |
| Aetna Medicare Advantage [20010] | Pb Sprg/Jopl/Cape/Stod Medicare Mo | $188 |
| Aetna Medicare Advantage Contracted [320010] | Pb Sprg/Jopl Aetna Med | $188 |
| BCBS Medicare Advantage Contracted [320047] | Pb Sprg/Jopl Blue Cross | $188 |
| Humana Medicare Advantage Contracted [320194] | Pb Sprg/Jopl/Ks Humana | $188 |
| Medicare [20244] | Pb Sprg/Jopl/Cape/Stod Medicare Mo 99 | $188 |
| Devoted Health Medicare Contracted [320500] | Pb Sprg-Jopl Devoted Hea | $195 |
| Medicaid [20240] | Pb Sprg/Jopl Medicaid Arkansas | $206 |
| Humana Contracted [320193] | Pb Jopl Humana/Ppox | $225 |
| Administrative Payor [20005] | Pb Mercy Amish/Mennonite | $226 |
| Administrative Payor Contracted [320005] | Pb Mercy Amish/Mennonite | $226 |
| Boon Chapman Contracted [320055] | Pb Jopl Krey Distributing | $226 |
| Healthsmart Preferred Care Contracted [320184] | Pb Sprg/Jopl Arvest B | $226 |
| BCBS Medicaid [20046] | Pb Sprg/Jopl Missouri Care/Healthy Blue | $236 |
| BCBS Medicaid Contracted [320046] | Pb Sprg/Jopl Missouri Care/Healthy | $236 |
| Blue Cross And Blue Shield [20053] | Pb Sprg/Jopl Anthem Alliance Outs | $238 |
| Mc Anthem [20455] | Pb Sprg/Jopl Anthem Alliance Outside Greene County | $238 |
| Blue Cross And Blue Shield [20053] | Pb Sprg Jopl Anthem Pathways X (E | $245 |
| Blue Cross And Blue Shield [20053] | Pb Sprg Jopl Anthem Blue Preferre | $247 |
| United Healthcare Contracted [320396] | Pb Sprg/Jopl United Healthcare | $249 |
| Blue Cross And Blue Shield [20053] | Pb Sprg Jopl Anthem Blue Access | $252 |
| Mc Generic Anthem [20456] | Pb Sprg Jopl Anthem Blue Access | $252 |
| Healthlink Contracted [320179] | Pb Sprg/Jopl Healthlink | $277 |
| Auxiant Contracted [320462] | Pb Sprg-Jopl Buchheit Dec | $283 |
| Mercy Benefit Admin [20251] | Pb Sprg-Jopl Bartel Comminications Dec | $283 |
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