CT abdomen and pelvis with contrast at Franciscan Health Michigan City. CPT 74177.
What Franciscan Health Michigan City publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$1,148cash price (self-pay)
$5,520list price
$369–$5,520range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicare [1099] | Medicare-Nir-Michigan City | $369 |
| Medicare Replacement [2003] | Medicare-Nir-Michigan City | $369 |
| Blue Cross [1014] | Anthem Blue Access PPO-Cid | $552 |
| Unicare [1150] | Anthem Blue Access PPO-Cid | $552 |
| Blue Cross Out Of State [1211] | Anthem Blue Access PPO-Cid | $552 |
| Alt Payer Indiana Blue Cross [121003] | Anthem Blue Access PPO-Cid | $552 |
| Medicaid Illinois [1091] | In Mcd-Nir-Michigan City | $632 |
| Medicaid [1092] | In Mcd-Nir-Michigan City | $632 |
| Mdwise [1175] | In Mcd-Nir-Michigan City | $632 |
| Alt Traditional Medicaid Secondary [109200] | In Mcd-Nir-Michigan City | $632 |
| Managed Health Services [1302] | In Mcd Michigan City Mhs 112% Of In M | $652 |
| Workers Comp [1172] | Workers Comp - Nir - Michigan City | $738 |
| Medicaid [1092] | In Mdc Mi City Caresource 120% Of In Mcd | $759 |
| Aetna [1005] | Aetna-Nid-Dyer-Munster-Crn Point | $846 |
| Managed Care [2000] | Aetna-Nid-Dyer-Munster-Crn Point | $846 |
| Cigna [1037] | Cigna Localplus-Nid | $850 |
| Managed Care [2000] | Siho - Cid & Nid & Wid Locations | $1,658 |
| United Healthcare [1156] | UHC All Payer-Nid-Michigan City | $1,916 |
| United Medical Resources [1158] | UHC All Payer-Nid-Michigan City | $1,916 |
| United Medical Resources [1301] | UHC All Payer-Nid-Michigan City | $1,916 |
| Managed Care [2000] | UHC All Payer-Nid-Michigan City | $1,916 |
| Commercial [2001] | UHC All Payer-Nid-Michigan City | $1,916 |
| Managed Care [2000] | UHC All Savers-Nid-Michigan City | $1,916 |
| United Healthcare [1156] | UHC Options PPO-Nid-Michigan City | $2,109 |
| United Medical Resources [1301] | UHC Options PPO-Nid-Michigan City | $2,109 |
| Managed Care [2000] | UHC Options PPO-Nid-Michigan City | $2,109 |
| Blue Cross Illinois [1210] | St Anthony Health-Nir-Stmar&Fhm&Stant Mc | $2,760 |
| Managed Care [2000] | Lutheran Preferred-Nid & Wid & Cid-Carme | $3,312 |
| Managed Care [2000] | First Health-Nid | $3,312 |
| Commercial [2001] | First Health-Nid | $3,312 |
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