CT abdomen and pelvis with contrast at Hospital Menonita Aibonito. CPT 74177.
What Hospital Menonita Aibonito publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$400cash price (self-pay)
$400list price
$179–$450range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Acaa | Acaa | $179 |
| First Medical (International Medical Card) | IMC Plan Salud Gobierno | $234 |
| MMM Multihealth Government Health | MMM Plan Salud Gobierno | $234 |
| Plan de Salud Menonita GHP | Plan Salud Menonita PSG | $234 |
| TRIPLE S MEDICARE ADVANTAGE | Triple-S Advantage | $238 |
| VA Caribbean Health Care System | Veterans Administration | $240 |
| Tricare Overseas | Tricare | $240 |
| First Medical (International Medical Card) | International Medical Car | $275 |
| Union de Carpintero | Union de Carpinteros | $275 |
| Plan de Salud Hospital Menonita | Plan de Salud Menonita | $300 |
| Mapfre (Canada Life) | Mapfre Crown Life | $400 |
| Triple S (SSS) | Triple-S Mi Salud | $414 |
| Medical Card System (MCS) | MCS Comercial | $420 |
| Humana | Humana Insurance | $427 |
| Triple S (SSS) | Triple-S | $450 |
| Asociacion de Maestros (PROSSAM) | Asociacion de Maestros de PR | $450 |
| Palic (Panamerican Life Insurance Company of Puerto Rico) | Pan Americ | $450 |
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