CT abdomen and pelvis with contrast at Mosaic Medical Center - Maryville. CPT 74177.
What Mosaic Medical Center - Maryville publishes for this service, straight from its standard-charges file, last updated September 26, 2025.
Outpatient / ER
$3,230cash price (self-pay)
$3,800list price
$81.78–$4,712range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina of Iowa | Managed Medicaid | $225 |
| Amerigroup of Iowa | Managed Medicaid | $225 |
| Iowa Total Care | Managed Medicaid | $225 |
| Blue Cross PCB | Commercial | $252 |
| Blue Cross PC | Commercial | $271 |
| Preferred Health Professional | Commercial | $271 |
| Blue Cross Blue Shield | Medicare Advantage | $305 |
| Aetna | Medicare Advantage | $305 |
| United Healthcare | Medicare Advantage | $305 |
| Ambetter | Commercial | $305 |
| United Healthcare | Commercial | $323 |
| Multiplan | Commercial | $353 |
| Aetna | Commercial | $1,760 |
| Cigna | Commercial | $2,626 |
| Sisco | Commercial | $2,626 |
| Centurion | Commercial | $2,660 |
| GEHA Shared Services | Commercial | $2,850 |
| Healthlink Open Access | Commercial | $3,230 |
| Freedom Select Healthlink | Commercial | $3,230 |
| United Healthcare of Missouri | Managed Medicaid | $4,005 |
| Home State of Missouri | Managed Medicaid | $4,180 |
| Healthy Blue of Missouri | Managed Medicaid | $4,712 |
Inpatient
$3,230cash price (self-pay)
$3,800list price
$1,520–$3,420range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Centurion | Commercial | $1,520 |
| Sisco | Commercial | $2,626 |
| Cigna | Commercial | $2,626 |
| United Healthcare | Commercial | $2,850 |
| GEHA Shared Services | Commercial | $2,850 |
| Healthlink Open Access | Commercial | $3,230 |
| Blue Cross PC | Commercial | $3,230 |
| Preferred Health Professional | Commercial | $3,230 |
| Blue Cross PCB | Commercial | $3,230 |
| Aetna | Commercial | $3,230 |
| Freedom Select Healthlink | Commercial | $3,230 |
| Multiplan | Commercial | $3,420 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.