CT abdomen and pelvis with contrast at Elkhart General Hospital. CPT 74177.
What Elkhart General Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$3,236cash price (self-pay)
$4,978list price
$201–$6,471range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Exchange | $374 |
| Anthem | Medicare Advantage | $374 |
| Humana | Medicare Advantage | $374 |
| Caresource | Exchange | $599 |
| Anthem | IN Medicaid HCC | $632 |
| Anthem | IN Medicaid HHW | $632 |
| Anthem | IN Medicaid HIP | $632 |
| Anthem | Pathways for Aging | $632 |
| Caresource | IN Medicaid HHW | $632 |
| Humana | Pathways for Aging | $632 |
| MHS | IN Medicaid HCC | $632 |
| MHS | IN Medicaid HCC BH | $632 |
| MHS | IN Medicaid HHW | $632 |
| Anthem | Workers Compensation | $711 |
| Devoted Healthcare | Medicare Advantage | $996 |
| Anthem | HealthSync | $1,042 |
| Anthem | Commercial | $1,226 |
| Aetna | Medicare Advantage | $2,240 |
| CHA | Employer Group 4 | $2,987 |
| Immergrun | Commercial | $2,987 |
| CHA | Employer Group 1 | $3,186 |
| MHS | Exchange | $3,236 |
| PHP | Commercial Select | $3,236 |
| CHA | Employer Group 2 | $3,285 |
| UHC | Commercial | $3,345 |
| Aetna | Commercial | $3,370 |
| Humana | Commercial | $3,485 |
| PHP | Commercial | $3,485 |
| Cigna | OAP | $3,584 |
| Multiplan | Commercial | $3,584 |
Inpatient
$3,236cash price (self-pay)
$4,978list price
$996–$6,471range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Devoted Healthcare | Medicare Advantage | $996 |
| CHA | Employer Group 1 | $3,186 |
| PHP | Commercial Select | $3,236 |
| CHA | Employer Group 2 | $3,285 |
| Aetna | Commercial | $3,370 |
| Humana | Commercial | $3,418 |
| PHP | Commercial | $3,485 |
| Cigna | OAP | $3,584 |
| Multiplan | Commercial | $3,584 |
| Signature | Commercial | $3,634 |
| Encore | Commercial | $3,684 |
| Cigna Sagamore | PPO | $3,783 |
| CHA | Employer Group 3 | $3,883 |
| Immergrun | Commercial | $3,982 |
| Plain Church | Commercial | $3,982 |
| Caresource | IN Medicaid HIP | $6,471 |
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