CT abdomen and pelvis with contrast at Cameron Memorial Community Hospital. CPT 74177.
What Cameron Memorial Community Hospital publishes for this service, straight from its standard-charges file, last updated February 18, 2026.
Outpatient / ER
$1,958cash price (self-pay)
$3,264list price
$162–$3,036range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Blue Cross of IN | Medicaid | $162 |
| CareSource Indiana of IN | Hoosier Healthwise/HIP | $162 |
| Managed Health Services | Medicaid | $162 |
| MDWise | Medicaid | $162 |
| Anthem Blue Cross of IN | Medicare | $1,012 |
| Aetna | Medicare | $1,044 |
| Humana | Medicare | $1,044 |
| United Healthcare | Medicare | $1,044 |
| CareSource Indiana of IN | Medicare | $1,149 |
| CareSource Indiana of IN | Just 4 Me | $1,201 |
| Anthem Blue Cross of IN | PPO/Pathway | $1,267 |
| Anthem Blue Cross of IN | Traditional | $1,267 |
| Plain Church Group Ministry | All Commercial | $1,273 |
| Centivo | All Commercial | $1,776 |
| Lucent | All Commercial | $1,776 |
| PHCS | All Commercial | $2,448 |
| PHP | All Commercial | $2,475 |
| Sagamore Health Network | All Products | $2,520 |
| United Healthcare | Commercial | $2,572 |
| Signature Care | EPO | $2,709 |
| Aetna | Commercial | $2,755 |
| Three Rivers Preferred | All Commercial | $2,774 |
| Cigna | All Commercial | $2,817 |
| Humana | ChoiceCare | $2,819 |
| Coventry | All Commercial | $2,872 |
| Signature Care | PPO | $2,872 |
| Lutheran Preferred | All Commercial | $2,938 |
| Frontpath | All Commercial | $3,003 |
| Encore | All Commercial | $3,005 |
| CORVEL | All Commercial | $3,036 |
Inpatient
$1,958cash price (self-pay)
$3,264list price
$2,448–$3,036range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| PHCS | All Commercial | $2,448 |
| PHP | All Commercial | $2,475 |
| Sagamore Health Network | All Products | $2,520 |
| United Healthcare | Commercial | $2,572 |
| Signature Care | EPO | $2,709 |
| Cigna | All Commercial | $2,817 |
| Humana | ChoiceCare | $2,819 |
| Aetna | Commercial | $2,820 |
| Coventry | All Commercial | $2,872 |
| Signature Care | PPO | $2,872 |
| Lutheran Preferred | All Commercial | $2,938 |
| Frontpath | All Commercial | $3,003 |
| Encore | All Commercial | $3,005 |
| CORVEL | All Commercial | $3,036 |
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