CT abdomen and pelvis with contrast at Merit Health Wesley. CPT 74177.
What Merit Health Wesley publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$3,735cash price (self-pay)
$17,785list price
$242–$14,228range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid | AL Medicaid | $242 |
| Magnolia | Magnolia Medicaid | $272 |
| Medicaid | MS Medicaid | $272 |
| Medicaid | MS Medicaid Non Par | $272 |
| United Healthcare | UHC Medicaid MS | $272 |
| Magnolia MCD MS CHIP | Magnolia MCD MS CHIP | $275 |
| Molina Medicaid MS | Molina Medicaid MS | $275 |
| CareSource TrueCare | CareSource TrueCare | $278 |
| Molina CHIP | Molina CHIP | $294 |
| NODE Tricare | NODE Tricare | $299 |
| Veterans Eval Services | Veterans Eval Services | $304 |
| First Choice | NODE First Choice Shared Health of MS MCR ADV | $305 |
| NODE Devoted Health MCR ADV | NODE Devoted Health MCR ADV | $311 |
| NODE First Choice American Health MCR ADV | NODE First Choice American | $311 |
| NODE First Choice Aetna MCR ADV | NODE First Choice Aetna MCR ADV | $314 |
| NODE ChampVA | NODE ChampVA | $315 |
| MS Work Comp | MS Work Comp | $446 |
| First Choice | First Choice Occunet | $465 |
| First Choice | First Choice Preferred | $465 |
| First Choice Molina | NODE First Choice Molina Exchange | $527 |
| Molina Exchange | Molina Exchange | $571 |
| First Choice LGP | First Choice LGP | $675 |
| United Healthcare | UHC APA | $764 |
| UHC Iex | UHC Iex | $764 |
| Advanced Health Systems | Advanced Health Systems | $917 |
| BCBS | BCBS Ms Fmp | $1,180 |
| CHS Group Health Plan UMR | CHS Group Health Plan UMR | $1,992 |
| LA Medicaid Non Par | LA Medicaid Non Par | $2,712 |
| Cigna | Cigna | $3,118 |
| CHS Group Health Plan | CHS Group Health Plan | $3,557 |
Inpatient
$5,336cash price (self-pay)
$17,785list price
$1,992–$14,228range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CHS Group Health Plan UMR | CHS Group Health Plan UMR | $1,992 |
| CHS Group Health Plan | CHS Group Health Plan | $3,557 |
| Self Pay | Self Pay | $5,336 |
| TriMed Billing Solutions | TriMed Billing Solutions LLC | $5,336 |
| First Choice | PHCS | $10,671 |
| First Choice | First Choice Stratose | $14,228 |
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