CT abdomen and pelvis with contrast at Marshfield Medical Center Weston Hospital. CPT 74177.
What Marshfield Medical Center Weston Hospital publishes for this service, straight from its standard-charges file, last updated February 20, 2026.
Outpatient / ER
$2,518cash price (self-pay)
$2,650list price
$1,286–$2,571range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Security Health Plan (SHP) | SimplyOne Region 3 | $1,286 |
| Family Health Center (FHC) | Prepaid Health Svcs | $1,325 |
| Security Health Plan (SHP) | SimplyOne Region 2 | $1,414 |
| Amish/Mennonite | Amish Mennonite | $1,458 |
| Sanford Health Plan | Commercial | $1,458 |
| Security Health Plan (SHP) | SimplyOne Region 1 | $1,540 |
| Security Health Plan (SHP) | SimplyOne QHP | $1,586 |
| Anthem BCBS of WI | HMO/POS | $1,592 |
| The Alliance | Premier SAS | $1,596 |
| Security Health Plan (SHP) | SimplyOne Region 4 | $1,617 |
| The Alliance | Premier | $1,645 |
| Security Health Plan (SHP) | EPO | $1,670 |
| Anthem BCBS of WI | PPO | $1,740 |
| Security Health Plan (SHP) | Broad | $1,758 |
| Anthem BCBS of WI | Traditional | $1,820 |
| The Alliance | Exception Members | $2,041 |
| Group Health Cooperative of Eau Claire | ETF - River Region | $2,173 |
| UnitedHealth Group of WI | PPO | $2,189 |
| The Alliance | PPO Network | $2,213 |
| Besse Forest Products | Direct Employer | $2,253 |
| Molina Healthcare of WI | HMO | $2,253 |
| Rice Lake School District | Direct Employer | $2,253 |
| WPS Health Insurance | PPO | $2,345 |
| Group Health Cooperative of Eau Claire | ETF - Greater WI/HMO | $2,385 |
| Medica of WI | PPO | $2,470 |
| Cigna | PPO | $2,491 |
| HealthEOS by MultiPlan Inc. | PPO Network | $2,491 |
| CORVEL | Third Party | $2,518 |
| First Health | PPO Network | $2,518 |
| HealthEOS by MultiPlan Inc. | Workers Comp | $2,518 |
Inpatient
$2,518cash price (self-pay)
$2,650list price
$1,458–$2,571range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amish/Mennonite | Amish Mennonite | $1,458 |
| Sanford Health Plan | Commercial | $1,458 |
| The Alliance | Exception Members | $2,041 |
| Group Health Cooperative of Eau Claire | ETF - River Region | $2,173 |
| The Alliance | PPO Network | $2,189 |
| UnitedHealth Group of WI | PPO | $2,189 |
| Besse Forest Products | Direct Employer | $2,253 |
| Molina Healthcare of WI | HMO | $2,253 |
| Rice Lake School District | Direct Employer | $2,253 |
| Group Health Cooperative of Eau Claire | ETF - Greater WI/HMO | $2,385 |
| Cigna | PPO | $2,491 |
| HealthEOS by MultiPlan Inc. | PPO Network | $2,491 |
| CORVEL | Third Party | $2,518 |
| First Health | PPO Network | $2,518 |
| HealthEOS by MultiPlan Inc. | Workers Comp | $2,518 |
| Health Partners | PPO | $2,518 |
| Three Rivers Provider Network (TRPN) | Commercial | $2,518 |
| Three Rivers Provider Network (TRPN) | Third Party | $2,518 |
| Medica of WI | Medica Care System | $2,523 |
| Trilogy | Commercial | $2,531 |
| Coventry | Workers Comp | $2,544 |
| Health Smart | PPO Network | $2,544 |
| Trilogy | Third Party | $2,544 |
| WPS Health Insurance | Indemnity | $2,557 |
| Rising Medical Work Comp | Workers Comp | $2,571 |
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All common services at Marshfield Medical Center Weston Hospital