CT abdomen and pelvis with contrast at SSM Health Waupun Memorial Hospital. CPT 74177.
What SSM Health Waupun Memorial Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$1,713cash price (self-pay)
$3,115list price
$729–$755range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS | Blue Preferred / Blue Preferred Plus HMO/POS | $729 |
| BCBS | Blue Access PPO | $755 |
| BCBS | Blue Traditional Traditional | $755 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.