CT abdomen and pelvis with contrast at Black River Memorial Hospital. CPT 74177.
What Black River Memorial Hospital publishes for this service, straight from its standard-charges file, last updated January 8, 2026.
Outpatient / ER
$1,209cash price (self-pay)
$1,383list price
$22.32–$4,221range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| My Choice Wisconsin, Inc. | Family Care / Family Care Partnership - Me | $60.92 |
| Anthem BCBS | Medicaid | $60.92 |
| Group Health Cooperative of Eau Claire | Medicaid | $60.92 |
| My Choice Wisconsin, Inc. | Medicaid SSI | $60.92 |
| Quartz Health Solutions, Inc | Medicaid/BadgerCare | $60.92 |
| Anthem BCBS | Medicare Advantage | $1,067 |
| My Choice Wisconsin, Inc. | Medicare Dual Advantage | $1,067 |
| Quartz Health Solutions, Inc | Senior Preferred | $1,067 |
| Security Health Plan | Badgercare Plus | $1,067 |
| Security Health Plan | Medicare Advantage | $1,067 |
| United Health Care | VA Plan | $1,067 |
| Humana | Medicare Advantage | $1,096 |
| United Health Care | Medicare Advantage | $1,096 |
| Corvel | Automobile liability / Accident & Health | $1,685 |
| Corvel | Workers' Compensation | $1,685 |
| Security Health Plan | Commercial | $1,945 |
| The Alliance | Health Plan | $1,978 |
| MultiPlan | Health Plan | $2,083 |
| Security Health Plan | EPO | $2,313 |
| The Alliance | Worker's Compensation | $2,347 |
| Triology Health Solutions | Health Plan | $2,485 |
| Quartz Health Solutions, Inc | Commercial / Self-Insured | $2,513 |
| Humana | Commercial | $2,568 |
| Medica | Health Plan | $2,579 |
| United Health Care | Commercial | $2,623 |
| Association Benefits Solution | Health Plan | $2,623 |
| First Health Group Corporation | MultiPlan PPC Network | $2,623 |
| Provider Network of America | Health Plan | $2,623 |
| Triology Health Solutions | Workers Compensation | $2,623 |
| Family Health Center of Marshfield | Health Plan | $2,623 |
Inpatient
$3,726cash price (self-pay)
$4,264list price
$2,111–$4,221range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| The Alliance | Health Plan | $4,093 |
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