CT abdomen and pelvis with contrast at IU Health Ball Memorial Hospital. CPT 74177.
What IU Health Ball Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$460cash price (self-pay)
$2,168list price
$371–$1,951range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | All Managed Medicare | $371 |
| Health Alliance | HMO/PPO Managed Medicare | $371 |
| Humana | All Managed Medicare HMO | $371 |
| United Healthcare | All Managed Medicare | $371 |
| Indiana University Health | All Managed Medicare | $371 |
| Elevance Health | All Managed Medicare - Out of network | $371 |
| Elevance Health | All Managed Medicare - In network | $371 |
| Zing Health | All Managed Medicare | $371 |
| Wellcare by Allwell | All Managed Medicare | $378 |
| Humana | All Managed Medicare PPO | $378 |
| Caresource | All Marketplace Plans | $557 |
| Elevance Health | All Managed Medicaid | $632 |
| Managed Health Services | All Government Medicaid | $632 |
| United Healthcare | All Managed Medicaid | $632 |
| Caresource | All Managed Medicaid | $632 |
| Caresource | All Government Medicaid HIP | $632 |
| Elevance Health | All Government Medicaid HIP | $632 |
| Managed Health Services | All Government Medicaid HIP | $632 |
| Sagamore Health Network/Cigna | PPO - NON-DRG | $725 |
| Aetna | PPO - IN Preferred | $725 |
| SIHO Insurance Services | HMO/POS Plans | $725 |
| Encore Health Network | PPO | $725 |
| Aetna | PPO/POS | $725 |
| Cigna | HMO | $725 |
| Cigna | HMO - Open Access | $725 |
| SIHO Insurance Services | All PPO Plans | $725 |
| Aetna | POS - Cox Medical Plans | $725 |
| Sagamore Health Network/Cigna | PPO - DRG Plans | $725 |
| Encore Health Network | PPO/HMO/EPO - Combined/Encircle | $725 |
| Cigna | PPO | $725 |
Inpatient
$703cash price (self-pay)
$3,315list price
$703–$2,984range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Self-Pay | Other - Self-Pay | $703 |
| SIHO Insurance Services | PPO - Union Health | $1,359 |
| Aetna | PPO - IN Preferred | $1,522 |
| Aetna | POS - Cox Medical Plans | $1,522 |
| Cigna | PPO - New Business | $1,525 |
| Community Health Direct | HMO - LaPorte Regional Plans | $1,956 |
| Parkview Health | HMO - Employee Plans | $2,049 |
| Unified Group Services | HMO | $2,055 |
| Sagamore Health Network/Cigna | PPO - NON-DRG | $2,065 |
| Aetna | HMO - Coventry Plans | $2,069 |
| Aetna | PPO/POS | $2,069 |
| Community Health Direct | HMO - ProHealth Plans | $2,321 |
| Lutheran Health Network | All Managed Care | $2,321 |
| Parkview Health | EPO | $2,390 |
| Aetna | PPO - NAP | $2,579 |
| Aetna | PPO - First Health | $2,579 |
| Indiana Health Network (IHN) | All Managed Care | $2,609 |
| SIHO Insurance Services | HMO/POS Plans | $2,619 |
| Lutheran Preferred | All PPO Plans | $2,652 |
| Encore Health Network | PPO | $2,652 |
| Parkview Health | PPO | $2,732 |
| SIHO Insurance Services | All PPO Plans | $2,785 |
| Multiplan | PPO - PHCS Private Healthcare Plans | $2,818 |
| Community Health Alliance | PPO | $2,984 |
| Multiplan | PPO - Multiplan Plans | $2,984 |
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