CT abdomen and pelvis with contrast at Gundersen Boscobel Area Hospital and Clinic. CPT 74177.
What Gundersen Boscobel Area Hospital and Clinic publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$2,002cash price (self-pay)
$3,887list price
$144–$3,732range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Medicaid HMO | $144 |
| Medical Associates | All Products | $685 |
| Anthem | Medicaid | $707 |
| Dean Health Plan | Medicaid_Badgercare | $707 |
| Group Health Eau Claire | Medicaid HMO | $707 |
| Group Health of South Central | Medicaid HMO | $707 |
| Iowa Total Care | Medicaid | $707 |
| Managed Health Service | Managed Medicaid | $707 |
| Quartz | Medicaid_Badgercare | $707 |
| Alliance | Comprehensive/All Products | $1,426 |
| Alliance | Premier/All Products | $1,426 |
| Quartz | All Products | $1,644 |
| Quartz | All Other Self Funded | $1,710 |
| Dean Health Plan | All Products | $1,759 |
| Quartz | Self Funded | $1,827 |
| Quartz | Level Funded | $1,885 |
| Anthem | Medicare HMO/PPO | $1,905 |
| Dean Health Plan | Medicare Select | $1,905 |
| Health Partners | Medicare Advantage | $1,905 |
| Humana | Medicare Advantage | $1,905 |
| Medical Associates | Medicare Advantage | $1,905 |
| Quartz | Medicare Advantage | $1,905 |
| Health Partners | Medicaid HMO | $1,944 |
| Anthem | State Specific | $2,092 |
| Quartz | Fully Insured | $2,118 |
| Anthem | HMO/POS | $2,202 |
| Health Partners | Medicare Cost | $2,332 |
| Anthem | PPO | $2,570 |
| Cigna | All Products | $2,997 |
| Group Health of South Central | All Products | $3,110 |
Inpatient
$2,002cash price (self-pay)
$3,887list price
$1,644–$3,732range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Other Self Funded | $2,289 |
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All common services at Gundersen Boscobel Area Hospital and Clinic