CT abdomen and pelvis with contrast at Mosaic Life Care at St Joseph Medical Center. CPT 74177.
What Mosaic Life Care at St Joseph Medical Center publishes for this service, straight from its standard-charges file, last updated September 26, 2025.
Outpatient / ER
$2,550cash price (self-pay)
$3,600list price
$71.10–$7,476range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup of Iowa | Managed Medicaid | $225 |
| Iowa Total Care | Managed Medicaid | $225 |
| Molina of Iowa | Managed Medicaid | $225 |
| Aetna of Kansas | Managed Medicaid | $252 |
| United Healthcare of Kansas | Managed Medicaid | $252 |
| Sunflower of Kansas | Managed Medicaid | $252 |
| Blue Cross HMO | Commercial | $314 |
| Blue Cross PCB | Commercial | $314 |
| Blue Cross PC | Commercial | $336 |
| Aetna | Medicare Advantage | $360 |
| Blue Cross Blue Shield | Medicare Advantage | $360 |
| United Healthcare | Medicare Advantage | $360 |
| United Healthcare | Commercial | $377 |
| Ambetter | Commercial | $684 |
| Aetna | Commercial | $2,481 |
| Centurion | Commercial | $2,520 |
| GEHA Shared Services | Commercial | $2,923 |
| Freedom Select Healthlink | Commercial | $3,091 |
| Healthlink Open Access | Commercial | $3,091 |
| Preferred Health Professional | Commercial | $3,091 |
| Sisco | Commercial | $3,091 |
| Cigna | Commercial | $3,168 |
| Multiplan | Commercial | $3,240 |
| United Healthcare of Missouri | Managed Medicaid | $5,076 |
| Home State of Missouri | Managed Medicaid | $5,220 |
| Healthy Blue of Missouri | Managed Medicaid | $6,408 |
Inpatient
$2,550cash price (self-pay)
$3,600list price
$1,200–$3,780range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Centurion | Commercial | $1,440 |
| Blue Cross HMO | Commercial | $2,722 |
| Blue Cross PCB | Commercial | $2,722 |
| GEHA Shared Services | Commercial | $2,923 |
| United Healthcare | Commercial | $2,923 |
| Aetna | Commercial | $2,977 |
| Freedom Select Healthlink | Commercial | $3,091 |
| Healthlink Open Access | Commercial | $3,091 |
| Preferred Health Professional | Commercial | $3,091 |
| Sisco | Commercial | $3,091 |
| Blue Cross PC | Commercial | $3,125 |
| Cigna | Commercial | $3,168 |
| Multiplan | Commercial | $3,240 |
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All common services at Mosaic Life Care at St Joseph Medical Center