CT abdomen and pelvis with contrast at Mercy Primary Care - 1165 East Cherry. CPT 74177.
What Mercy Primary Care - 1165 East Cherry publishes for this service, straight from its standard-charges file, last updated June 12, 2026.
Outpatient / ER
$161cash price (self-pay)
$214list price
$29.81–$199range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Boon Chapman Contracted [320055] | Pb Stl Dec Krey Distributing | $29.81 |
| Mercy Benefit Admin Contracted [320251] | Pb Stl Dec Epworth | $29.81 |
| Mercy Benefit Admin [20251] | Pb Stl Dec Hermann | $33.51 |
| Mercy Benefit Admin Contracted [320251] | Pb Stl Dec Hermann | $33.51 |
| Medicaid [20240] | Pb Stl Illinois Public Aid (IL Mcd) | $57.95 |
| Aetna Medicare Advantage Contracted [320010] | Pb Stl Cape Aetna Medic | $81.24 |
| Medicare [20244] | Pb Stl Mcr Area 99 | $81.24 |
| Aetna Medicare Advantage Contracted [320010] | Pb Stl Aetna Medicare O | $83.25 |
| Cigna Medicare Advantage Contracted [320072] | Pb Stl Cigna Mcr | $83.25 |
| Essence Healthcare Medicare Contracted [320122] | Pb Stl Essence Healt | $83.25 |
| Devoted Health Medicare Contracted [320500] | Pb Stl Devoted Mcr Adv M | $84.49 |
| Humana Medicare Advantage [20194] | Pb IL Humana Mcr-Mcd Dsnp | $86.31 |
| Humana Medicare Advantage Contracted [320194] | Pb IL Humana Mcr-Mcd D | $86.31 |
| American Health Advantage Of Mo Mcr [10473] | Pb Stl Missouri Medicare | $87.41 |
| BCBS Medicaid Contracted [320046] | Pb Stl Missouri Care/Healthy Blue | $87.82 |
| Healthlink Contracted [320179] | Pb Stl Dec Healthlink HMO A2 | $101 |
| Healthlink Contracted [320179] | Pb Stl Healthlink HMO Fsc A2 (Pain At | $101 |
| Cigna Healthcare Contracted [320071] | Pb Stl Cigna Connect D1-2 | $105 |
| Blue Cross And Blue Shield [20053] | Pb Stl Blue Preferred Fsc 4 Contr | $106 |
| Blue Cross And Blue Shield [20053] | Pb Stl BCBS Ascension | $107 |
| Healthlink Contracted [320179] | Pb Stl Healthlink PPO Fsc A1 (Pain At | $108 |
| Blue Cross And Blue Shield [20053] | Pb Stl Blue Access Choice Fsc 4 C | $109 |
| Centivo Contracted [320505] | Pb Stl Centivo Commercial Mo 99 | $110 |
| Blue Cross And Blue Shield [20053] | Pb Stl Blue Access Fsc 4 Contract | $116 |
| Mc Anthem [20455] | Pb Stl Blue Access Fsc 4 Contract | $116 |
| Medica [20239] | Pb Stl Medica | $117 |
| Medica Contracted [320239] | Pb Stl Medica | $117 |
| Humana Contracted [320193] | Pb Stl Humana / Choicecare Commercial | $117 |
| Administrative Payor [20005] | Pb Mercy Amish/Mennonite | $118 |
| Administrative Payor Contracted [320005] | Pb Mercy Amish/Mennonite | $118 |
Inpatient
$161cash price (self-pay)
$214list price
$29.81–$199range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Boon Chapman Contracted [320055] | Pb Stl Dec Krey Distributing | $29.81 |
| Mercy Benefit Admin Contracted [320251] | Pb Stl Dec Epworth | $29.81 |
| Mercy Benefit Admin [20251] | Pb Stl Dec Hermann | $33.51 |
| Mercy Benefit Admin Contracted [320251] | Pb Stl Dec Hermann | $33.51 |
| Medicaid [20240] | Pb Stl Illinois Public Aid (IL Mcd) | $57.95 |
| Aetna Medicare Advantage Contracted [320010] | Pb Stl Cape Aetna Medic | $81.24 |
| Medicare [20244] | Pb Stl Mcr Area 99 | $81.24 |
| Aetna Medicare Advantage Contracted [320010] | Pb Stl Aetna Medicare O | $83.25 |
| Cigna Medicare Advantage Contracted [320072] | Pb Stl Cigna Mcr | $83.25 |
| Essence Healthcare Medicare Contracted [320122] | Pb Stl Essence Healt | $83.25 |
| Devoted Health Medicare Contracted [320500] | Pb Stl Devoted Mcr Adv M | $84.49 |
| Humana Medicare Advantage [20194] | Pb IL Humana Mcr-Mcd Dsnp | $86.31 |
| Humana Medicare Advantage Contracted [320194] | Pb IL Humana Mcr-Mcd D | $86.31 |
| American Health Advantage Of Mo Mcr [10473] | Pb Stl Missouri Medicare | $87.41 |
| BCBS Medicaid Contracted [320046] | Pb Stl Missouri Care/Healthy Blue | $87.82 |
| Healthlink Contracted [320179] | Pb Stl Dec Healthlink HMO A2 | $101 |
| Healthlink Contracted [320179] | Pb Stl Healthlink HMO Fsc A2 (Pain At | $101 |
| Cigna Healthcare Contracted [320071] | Pb Stl Cigna Connect D1-2 | $105 |
| Blue Cross And Blue Shield [20053] | Pb Stl Blue Preferred Fsc 4 Contr | $106 |
| Blue Cross And Blue Shield [20053] | Pb Stl BCBS Ascension | $107 |
| Healthlink Contracted [320179] | Pb Stl Healthlink PPO Fsc A1 (Pain At | $108 |
| Blue Cross And Blue Shield [20053] | Pb Stl Blue Access Choice Fsc 4 C | $109 |
| Centivo Contracted [320505] | Pb Stl Centivo Commercial Mo 99 | $110 |
| Blue Cross And Blue Shield [20053] | Pb Stl Blue Access Fsc 4 Contract | $116 |
| Mc Anthem [20455] | Pb Stl Blue Access Fsc 4 Contract | $116 |
| Medica [20239] | Pb Stl Medica | $117 |
| Medica Contracted [320239] | Pb Stl Medica | $117 |
| Humana Contracted [320193] | Pb Stl Humana / Choicecare Commercial | $117 |
| Administrative Payor [20005] | Pb Mercy Amish/Mennonite | $118 |
| Administrative Payor Contracted [320005] | Pb Mercy Amish/Mennonite | $118 |
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All common services at Mercy Primary Care - 1165 East Cherry