CT abdomen and pelvis with contrast at Franciscan Health Indianapolis. CPT 74177.
What Franciscan Health Indianapolis publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$781cash price (self-pay)
$3,381list price
$369–$3,381range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicare [1099] | Medicare-Cir-Indianapolis | $369 |
| Medicare Replacement [2003] | Medicare-Cir-Indianapolis | $388 |
| Medicare Replacement [2003] | Provider Partners Medicare Replacement [ | $406 |
| Blue Cross [1014] | Anthem Blue Access PPO-Cid | $552 |
| Blue Cross [1014] | Anthem HMO [101405] | $552 |
| Blue Cross [1014] | Anthem PPO [101407] | $552 |
| Blue Cross [1014] | Anthem Healthsync Hpn [322022] | $552 |
| Blue Cross [1014] | Anthem Healthsync [319068] | $552 |
| Blue Cross [1014] | Anthem Franciscan Alliance Employee Ins [319071] | $552 |
| Blue Cross Out Of State [1211] | Blue Cross Out Of State [322023] | $552 |
| Mdwise [1175] | In Mcd-Cir-Indianapolis | $632 |
| Medicaid [1092] | In Mcd-Cir-Indianapolis | $632 |
| Medicaid Illinois [1091] | In Mcd-Cir-Indianapolis | $632 |
| Alt Traditional Medicaid Secondary [109200] | In Mcd-Cir-Indianapolis | $632 |
| Medicaid [1092] | Anthem Medicaid [109201] | $632 |
| Medicaid [1092] | Medicaid In Traditional [109206] | $632 |
| Medicaid [1092] | Anthem Healthy Indiana Plan [301498] | $632 |
| Medicaid [1092] | Anthem Care Connect [315015] | $632 |
| Medicaid [1092] | Mdwise Excel Hip [318028] | $632 |
| Medicaid [1092] | Mdwise Excel Hhw [318029] | $632 |
| Medicaid [1092] | Anthem Pathways For Aging [324049] | $632 |
| Medicaid [1092] | Humana Healthy Horizons In Indiana [324050] | $632 |
| Medicaid [1092] | United Healthcare Pathways For The Aging [324051] | $632 |
| Managed Health Services [1302] | In Mcd Ind-Carmel-Car Ort 112% Of In | $652 |
| WORKERS COMP [1172] | Workers Comp - CIR - INDIANAPOLIS | $738 |
| Medicaid [1092] | In Mcd-Indianapol Caresource 120% In Mcd | $759 |
| United Healthcare [1156] | United Healthcare Charter-Cid | $1,651 |
| Managed Care [2000] | Siho - Cid & Nid & Wid Locations | $1,658 |
| Managed Care [2000] | United Healthcare-Cid | $1,684 |
| United Healthcare [1156] | United Healthcare-Cid | $1,684 |
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