CT abdomen and pelvis with contrast at Mid Coast Medical Center - Wharton. CPT 74177.
What Mid Coast Medical Center - Wharton publishes for this service, straight from its standard-charges file, last updated March 1, 2026.
Outpatient / ER
$1,234cash price (self-pay)
$1,234list price
$234–$926range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina | Medicare Advantage | $234 |
| TriWest | Medicare Advantage | $234 |
| United HealthCare | Medicare Advantage | $234 |
| Community Health Choice | Medicare Advantage | $246 |
| Amerigroup | Managed Medicaid | $383 |
| Aetna Health Inc. | Managed Medicaid | $383 |
| Community Health Choice | Managed Medicaid | $383 |
| Molina | Managed Medicaid | $383 |
| Texas Children's Health Plan | Managed Medicaid | $383 |
| United HealthCare | Managed Medicaid | $383 |
| Aetna Health Inc. | Medicare Advantage | $407 |
| Blue Cross Blue Sheild | BAV | $617 |
| United HealthCare | Commercial | $754 |
| Aetna Health Inc. | Commercial | $926 |
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