CT abdomen and pelvis with contrast at Adams Memorial Hospital. CPT 74177.
What Adams Memorial Hospital publishes for this service, straight from its standard-charges file, last updated August 14, 2026.
Outpatient / ER
$2,596cash price (self-pay)
$2,596list price
$162–$2,596range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UHC Mcaid | UHC Mcaid | $162 |
| Amerihealth Caritas Medicaid - All Plans | Amerihealth Caritas Medicai | $162 |
| Buckeye Mcaid | Buckeye Mcaid | $162 |
| Caresource Hoosier | Caresource Hoosier | $162 |
| Humana Choicecare Mcaid | Humana Choicecare Mcaid | $162 |
| Mdwise Mcaid | Mdwise Mcaid | $162 |
| Caresource Oh Mcaid | Caresource Oh Mcaid | $289 |
| Anthem Pathway X/Healthsync | Anthem Pathway X/Healthsync | $461 |
| Anthem Trad/PPO/HMO/Path - All Others | Anthem Trad/PPO/HMO/Path - All | $576 |
| Humana Choicecare Mcr PPO | Humana Choicecare Mcr PPO | $600 |
| Encore PPO - All Plans | Encore PPO - All Plans | $1,000 |
| Aetna - All Other Plans | Aetna - All Other Plans | $1,038 |
| Anthem Mcr Adv | Anthem Mcr Adv | $1,168 |
| Buckeye Mcare - All Other Plans | Buckeye Mcare - All Other Plans | $1,168 |
| Caresource Hlthy In | Caresource Hlthy In | $1,168 |
| Mdwise Hip | Mdwise Hip | $1,168 |
| Mhs Mcare | Mhs Mcare | $1,168 |
| Paramount Comm - All Other Plans | Paramount Comm - All Other Plans | $1,168 |
| Anthem Hlthy In | Anthem Hlthy In | $1,168 |
| Caresource Mcr Adv | Caresource Mcr Adv | $1,168 |
| Caresource Oh Marketplace | Caresource Oh Marketplace | $1,168 |
| Caresource Oh Mcare | Caresource Oh Mcare | $1,168 |
| Mdwise Mcr Adv | Mdwise Mcr Adv | $1,168 |
| Aetna Mcr Adv | Aetna Mcr Adv | $1,192 |
| Valor Health Plan - All Plans | Valor Health Plan - All Plans | $1,203 |
| Caresource Comm - All Other Plans | Caresource Comm - All Other Plans | $1,285 |
| Mhs Comm - All Other Plans | Mhs Comm - All Other Plans | $1,285 |
| Php Hp | Php Hp | $1,298 |
| Gpa - All Plans | Gpa - All Plans | $1,308 |
| Iu Health Comm - All Other Plans | Iu Health Comm - All Other Plans | $1,402 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.