CT abdomen and pelvis with contrast at Ascension St. Vincent Seton (St. Vincent Seton Specialty Hospital, Inc.). CPT 74177.
What Ascension St. Vincent Seton (St. Vincent Seton Specialty Hospital, Inc.) 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 |
| Smarthealth PPO | 2911_smarthealth PPO 20170101 | $233 |
| Smarthealth PPO/HDHP 20161001 | 1440_smarthealth PPO/HDHP 20161001 | $233 |
| UHC | 9470_united Healthcare Vein 20250101 | $244 |
| UHC Self | 6575_united Health Care Self Funded Non-Contracted Vein 202 | $244 |
| Anthem Healthsync HMO | 9399_anthem Healthsync HMO Vein 20250101 | $444 |
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All common services at Ascension St. Vincent Seton (St. Vincent Seton Specialty Hospital, Inc.)