CT abdomen and pelvis with contrast at Ascension St. Vincent Endoscopy. CPT 74177.
What Ascension St. Vincent Endoscopy publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$542cash price (self-pay)
$904list price
$65.14–$650range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Care Connect | 8255_anthem Connect Medicaid Replacement Outpat | $157 |
| Anthem Care Connect | 8879_anthem Connect Medicaid Replacement Asc Out | $157 |
| Anthem Medicaid | 7373_anthem Medicaid Replacement Outpatient 20230101 | $157 |
| Mdwise Hoosier Alliance Medicaid | 8256_mdwise Medicaid Replacement Ou | $157 |
| Mdwise Hoosier Alliance Medicaid | 9347_mdwise Medicaid Replacement As | $157 |
| Medicaid Advantage | 8723_medicaid Replacement Outpatient 20240401 | $157 |
| Medicaid Replacement Asc Outpatient 20250101 | 9365_medicaid Replaceme | $157 |
| Mhs Care Connect | 8257_mhs Connect Medicaid Replacement Outpatient 2 | $157 |
| Mhs Care Connect | 8877_mhs Connect Medicaid Replacement Asc Outpatien | $157 |
| Aetna Mcr | 8946_aetna Medicare Replacement Asc Outpatient Asin, Ecin, | $233 |
| Aetna Mcr Choice | 8955_aetna Choice Medicare Replacement Asc Outpatie | $233 |
| Anthem Mcr | 8964_anthem Medicare Replacement Asc Outpatient Asin, Eci | $233 |
| Ascension Complete Mcr | 9108_ascension Complete Medicare Replacement | $233 |
| Caresource HMO Medicare Advantage | 8973_caresource HMO Medicare Repla | $233 |
| Caresource Marketplace | 9054_caresource Marketplace Medicare Replacem | $233 |
| Corizon | 9072_corizon Medicare Replacement Asc Outpatient Asin, Ecin, | $233 |
| Humana Gold Mcr | 9000_humana Gold Choice Medicare Replacement Asc Out | $233 |
| Humana Mcr Choice | 8991_humana Choice Medicare Replacement Asc Outpat | $233 |
| Humana PPO Mcr Replacement | 8982_humana PPO Medicare Replacement Asc | $233 |
| Immergrun | 9081_immergrun Medicare Replacement Asc Outpatient Asin, E | $233 |
| Mdwise Medicare | 9090_mdwise Medicare Replacement Asc Outpatient Asin | $233 |
| Medicare Replacement | 9063_medicare Replacement Asc Outpatient Asin, | $233 |
| Mhs Cenpatico Ambetter | 9036_mhs Cenpatico Ambetter Medicare Replacem | $233 |
| Personalized Care | 9045_ascension Personalized Care Medicare Replacem | $233 |
| Secure Horizons-Pacificare | 9099_secure Horizons Pacificare Medicare | $233 |
| UHC | 9470_united Healthcare Vein 20250101 | $244 |
| UHC Self | 6575_united Health Care Self Funded Non-Contracted Vein 202 | $244 |
| UHC New | 6793_united Healthcare New Business Outpatient Ecin 20230101 | $316 |
| Anthem Healthsync HMO | 9399_anthem Healthsync HMO Vein 20250101 | $444 |
| Anthem Healthsync POS | 9401_anthem Healthsync POS Vein 20250101 | $444 |
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