CT abdomen and pelvis with contrast at Franciscan Health Mooresville. CPT 74177.
What Franciscan Health Mooresville publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$859cash price (self-pay)
$3,381list price
$369–$3,381range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicare [1099] | Medicare-Cir-Mooresville | $369 |
| Medicare Replacement [2003] | Medicare-Cir-Mooresville | $406 |
| 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-Cir-Mooresville | $632 |
| Medicaid [1092] | In Mcd-Cir-Mooresville | $632 |
| Mdwise [1175] | In Mcd-Cir-Mooresville | $632 |
| Alt Traditional Medicaid Secondary [109200] | In Mcd-Cir-Mooresville | $632 |
| Managed Health Services [1302] | In Mcd Moorseville Mhs 112% Of In Mcd | $652 |
| Workers Comp [1172] | Workers Comp - Cir - Mooresville | $738 |
| Medicaid [1092] | In Mcd-Mooresv Caresource 120% Of In Mdc | $759 |
| Aetna [1005] | Aetna-Nid-Dyer-Munster-Crn Point | $846 |
| Managed Care [2000] | Aetna-Nid-Dyer-Munster-Crn Point | $846 |
| Blue Cross [1014] | Anthem Franciscan Employee Copps- All Locations | $893 |
| Blue Cross [1014] | Anthem Healthsync HMO With Copps - Mooresville | $1,237 |
| Blue Cross [1014] | Anthem Healthsync POS With Copps - Mooresville | $1,401 |
| Blue Cross [1014] | Anthem Blue Access PPO With Copps - Mooresville | $1,566 |
| Unicare [1150] | Anthem Blue Access PPO With Copps - Mooresville | $1,566 |
| Blue Cross Illinois [1210] | Anthem Blue Access PPO With Copps - Moore | $1,566 |
| Blue Cross Out Of State [1211] | Anthem Blue Access PPO With Copps - M | $1,566 |
| Alt Payer Illinois Blue Cross [121002] | Anthem Blue Access PPO With C | $1,566 |
| Alt Payer Indiana Blue Cross [121003] | Anthem Blue Access PPO With Co | $1,566 |
| United Healthcare [1156] | United Healthcare Charter-Cid | $1,651 |
| Managed Care [2000] | Siho - Cid & Nid & Wid Locations | $1,658 |
| Managed Care [2000] | Encore - Cid & Nid & Wid & Sscd | $1,658 |
| Commercial [2001] | Encore - Cid & Nid & Wid & Sscd | $1,658 |
| United Healthcare [1156] | United Healthcare-Cid | $1,684 |
| United Medical Resources [1158] | United Healthcare-Cid | $1,684 |
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