CT abdomen and pelvis with contrast at Mount Carmel Grove City. CPT 74177.
What Mount Carmel Grove City publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$2,080cash price (self-pay)
$3,200list price
$290–$3,200range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medigold Medicare Advantage | Medigold Medicare Advantage | $290 |
| Blue Cross - Oh (Anthem) Medicare Advantage | Anthem BCBS Medicare Adv | $323 |
| Medical Mutual Medicare | Medical Mutual Medicare Advantage | $330 |
| Caresource Medicare | Caresource Medicare Advantage | $340 |
| Univera Healthcare Medicare Advantage | Universal Medicare Advantage | $347 |
| United Healthcare | United Healthcare Exchange | $715 |
| Blue Cross - Oh (Anthem) | Anthem BCBS Pathway Grp HMO | $1,044 |
| United Healthcare | United Healthcare PPO | $1,182 |
| Western & Southern Financial Group | Medical Mutual Oh Supermed PPO Po | $1,197 |
| Blue Cross - Ne | Anthem Blue Access PPO Blue Pref HMO | $1,255 |
| Blue Cross - Mo (Anthem) | Anthem Blue Access PPO Blue Pref HMO | $1,255 |
| Blue Cross - Nd | Anthem Blue Access PPO Blue Pref HMO | $1,255 |
| Blue Cross - Ks | Anthem Blue Access PPO Blue Pref HMO | $1,255 |
| Blue Cross - In (Anthem) | Anthem Blue Access PPO Blue Pref HMO | $1,255 |
| Blue Cross - Hi | Anthem Blue Access PPO Blue Pref HMO | $1,255 |
| Blue Cross - Ga (Anthem) | Anthem Blue Access PPO Blue Pref HMO | $1,255 |
| Blue Cross - Az | Anthem Blue Access PPO Blue Pref HMO | $1,255 |
| Blue Cross - Ak (Premera) | Anthem Blue Access PPO Blue Pref HMO | $1,255 |
| Blue Cross - Al | Anthem Blue Access PPO Blue Pref HMO | $1,255 |
| Blue Cross - Sd (Wellmark) | Anthem Blue Access PPO Blue Pref HMO | $1,255 |
| Meritain | Aetna Asa Meritain | $1,437 |
| Healthez | Aetna Asa Meritain | $1,437 |
| Access Health | Cofinity | $1,494 |
| Varipro | Cofinity | $1,494 |
| Forest County Potawatomi | Cofinity | $1,494 |
| Preferred One | Cofinity | $1,494 |
| Group Marketing Services | Cofinity | $1,494 |
| Mutual Of Omaha | Cofinity | $1,494 |
| Benefit Administrative Systems,LLC | Cofinity | $1,494 |
| Trustmark Small Business Benefits | Cofinity | $1,494 |
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