CT abdomen and pelvis with contrast at Mercy Primary Care - Bloomfield. CPT 74177.
What Mercy Primary Care - Bloomfield publishes for this service, straight from its standard-charges file, last updated June 12, 2026.
Outpatient / ER
$101cash price (self-pay)
$134list price
$59.69–$134range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Meridian Medicaid Contracted [320430] | Pb Meridian IL Mcd Health Plan | $59.69 |
| Medicaid [20240] | Pb Sprg/Jopl/Cape/Stod Medicaid Mo | $66.03 |
| Administrative Payor [20005] | Pb Mercy Amish/Mennonite | $73.70 |
| Administrative Payor Contracted [320005] | Pb Mercy Amish/Mennonite | $73.70 |
| Aetna Medicare Advantage [20010] | Pb Sprg/Jopl/Cape/Stod Medicare Mo | $81.24 |
| Medicare [20244] | Pb Sprg/Jopl/Cape/Stod Medicare Mo 99 | $81.24 |
| 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 |
| Blue Cross And Blue Shield [20053] | Pb Stod Anthem Blue Access Choice | $93.03 |
| Mc Anthem [20455] | Pb Stod Anthem Blue Access Choice - Blue Pref - Pa | $93.03 |
| Multiplan [20270] | Pb Cape / Stod Multiplan Comm 75% | $101 |
| Multiplan Contracted [320270] | Pb Cape / Stod Multiplan Comm 75% | $101 |
| United Healthcare Contracted [320396] | Pb Stl UHC Core | $105 |
| Centivo Contracted [320505] | Pb Pcmh Cape Stod Centivo | $110 |
| Workers Comp [20426] | Pb Cape/ Stod Multiplan Work Comp 85% | $114 |
| United Healthcare Contracted [320396] | Pb Cape-Stod UHC Core | $116 |
| United Healthcare Contracted [320396] | Pb Cape Stod UHC Exchange - If | $117 |
| Workers Comp [20426] | Pb Cape/ Stod Multiplan Auto Medical 90% | $121 |
| Cigna Healthcare Contracted [320071] | Pb Cape/Stod Cigna | $124 |
| Mercy Benefit Admin Contracted [320251] | Pb Stl Dec Employer Benefit | $127 |
| 90 Degree Benefits Contracted [320436] | Pb Cape Stod Dec Coastal Ener | $134 |
| Auxiant [20462] | Pb Cape Stod Dec Buchheit | $134 |
| Auxiant Contracted [320462] | Pb Cape Stod Dec Buchheit | $134 |
| Blue Cross And Blue Shield [20053] | Pb Cape/Stod Anthem Blue Traditio | $134 |
| Ebms Contracted [320493] | Pb Cape Stod Dec Crader Distributing | $134 |
| Hope Trust Contracted [320488] | Pb Cape Stod Dec Hope Trust Area 99 | $134 |
| Imagine 360 Contracted [320494] | Pb Cape Stod Dec Robinson Constructi | $134 |
| Mercy Benefit Admin Contracted [320251] | Pb Cape Stod Dec City Of Jac | $134 |
| Reflect Health [20492] | Pb Cape Stod Dec Ww Wood Products | $134 |
| Reflect Health Contracted [320492] | Pb Cape Stod Dec Ww Wood Products | $134 |
Inpatient
$101cash price (self-pay)
$134list price
$59.69–$134range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Meridian Medicaid Contracted [320430] | Pb Meridian IL Mcd Health Plan | $59.69 |
| Medicaid [20240] | Pb Sprg/Jopl/Cape/Stod Medicaid Mo | $66.03 |
| Administrative Payor [20005] | Pb Mercy Amish/Mennonite | $73.70 |
| Administrative Payor Contracted [320005] | Pb Mercy Amish/Mennonite | $73.70 |
| Aetna Medicare Advantage [20010] | Pb Sprg/Jopl/Cape/Stod Medicare Mo | $81.24 |
| Medicare [20244] | Pb Sprg/Jopl/Cape/Stod Medicare Mo 99 | $81.24 |
| 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 |
| Blue Cross And Blue Shield [20053] | Pb Stod Anthem Blue Access Choice | $93.03 |
| Mc Anthem [20455] | Pb Stod Anthem Blue Access Choice - Blue Pref - Pa | $93.03 |
| Multiplan [20270] | Pb Cape / Stod Multiplan Comm 75% | $101 |
| Multiplan Contracted [320270] | Pb Cape / Stod Multiplan Comm 75% | $101 |
| United Healthcare Contracted [320396] | Pb Stl UHC Core | $105 |
| Centivo Contracted [320505] | Pb Pcmh Cape Stod Centivo | $110 |
| Workers Comp [20426] | Pb Cape/ Stod Multiplan Work Comp 85% | $114 |
| United Healthcare Contracted [320396] | Pb Cape-Stod UHC Core | $116 |
| United Healthcare Contracted [320396] | Pb Cape Stod UHC Exchange - If | $117 |
| Workers Comp [20426] | Pb Cape/ Stod Multiplan Auto Medical 90% | $121 |
| Cigna Healthcare Contracted [320071] | Pb Cape/Stod Cigna | $124 |
| Mercy Benefit Admin Contracted [320251] | Pb Stl Dec Employer Benefit | $127 |
| 90 Degree Benefits Contracted [320436] | Pb Cape Stod Dec Coastal Ener | $134 |
| Auxiant [20462] | Pb Cape Stod Dec Buchheit | $134 |
| Auxiant Contracted [320462] | Pb Cape Stod Dec Buchheit | $134 |
| Blue Cross And Blue Shield [20053] | Pb Cape/Stod Anthem Blue Traditio | $134 |
| Ebms Contracted [320493] | Pb Cape Stod Dec Crader Distributing | $134 |
| Hope Trust Contracted [320488] | Pb Cape Stod Dec Hope Trust Area 99 | $134 |
| Imagine 360 Contracted [320494] | Pb Cape Stod Dec Robinson Constructi | $134 |
| Mercy Benefit Admin Contracted [320251] | Pb Cape Stod Dec City Of Jac | $134 |
| Reflect Health [20492] | Pb Cape Stod Dec Ww Wood Products | $134 |
| Reflect Health Contracted [320492] | Pb Cape Stod Dec Ww Wood Products | $134 |
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