CT abdomen and pelvis with contrast at Mercy Specialty Hospital - Southeast Kansas. CPT 74177.
What Mercy Specialty Hospital - Southeast Kansas publishes for this service, straight from its standard-charges file, last updated June 9, 2026.
Outpatient / ER
$3,543cash price (self-pay)
$5,451list price
$189–$5,178range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana Medicaid Contracted [320486] | Hb Seks Ok Medicaid | $189 |
| Oklahoma Complete Health Medicaid Contracted [320485] | Hb Seks Ok Med | $189 |
| Medicaid [20240] | Hb Seks Ok Medicaid | $189 |
| Aetna Medicaid Contracted [320009] | Hb Seks Ok Medicaid | $189 |
| Provider Partners Health Plans Contracted [320450] | Hb Seks Provider | $203 |
| Medicaid [20240] | Hb Seks Ark Medicaid | $206 |
| BCBS Medicaid Contracted [320046] | Hb Seks Medicaid Kancare | $207 |
| Kancare Contracted [320213] | Hb Seks Medicaid Kancare | $207 |
| Kancare Contracted [320213] | Hb Seks UHC Ks Medicaid | $207 |
| Aetna Contracted [320008] | Hb Seks Aetna Commercial/Firsthealth | $278 |
| First Health Contracted [320128] | Hb Seks Aetna Commercial/Firsthealt | $278 |
| United Healthcare Medicaid Contracted [320397] | Hb Seks UHC Mo Medica | $304 |
| Medicaid [20240] | Hb Seks Mo Medicaid | $304 |
| Home State Medicaid Contracted [320189] | Hb Seks Home State Mo Medica | $304 |
| BCBS Medicaid Contracted [320046] | Hb Seks Healthy Blue Mo Medicaid | $304 |
| Optum Health Behavioral Solutions [520250] | Hb Seks UHC | $351 |
| United Medical Resources Contracted [320454] | Hb Seks UHC | $351 |
| United Healthcare Contracted [320396] | Hb Seks UHC | $351 |
| United Healthcare Contracted [320396] | Hb Seks UHC Exchange | $351 |
| Longevity Health Plan Medicare Contracted [320225] | Hb Seks Mgd Medic | $359 |
| Qual Choice Contracted [320325] | Hb Seks Mgd Medicare | $359 |
| Sunflower Health Plan Contracted [320369] | Hb Seks Mgd Medicare | $359 |
| Tricare Contracted [320380] | Hb Seks Tricare | $359 |
| Mercy Mgd Behavioral Health Contracted [320259] | Hb Seks Mgd Medicare | $359 |
| HUMANA MEDICARE ADVANTAGE CONTRACTED [320194] | HB SEKS HUMANA MCR New | $365 |
| Blue Cross And Blue Shield [20053] | Hb Seks Blue Cross Choice | $466 |
| Mc Generic Anthem [20456] | Hb Seks Blue Cross Choice | $466 |
| Mc Anthem [20455] | Hb Seks Blue Cross Choice | $466 |
| Blue Cross And Blue Shield [20053] | Hb Seks Blue Cross Cap | $490 |
| Insurance System Inc Contracted [320465] | Hb Seks Dec Health Systems | $922 |
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All common services at Mercy Specialty Hospital - Southeast Kansas