CT abdomen and pelvis with contrast at IU Health North Hospital. CPT 74177.
What IU Health North Hospital publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$616cash price (self-pay)
$2,168list price
$370–$1,951range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Elevance Health | All Managed Medicare - Out of network | $370 |
| Health Alliance | HMO/PPO Managed Medicare | $370 |
| Humana | All Managed Medicare HMO | $370 |
| Indiana University Health | All Managed Medicare | $370 |
| Zing Health | All Managed Medicare | $370 |
| United Healthcare | All Managed Medicare | $370 |
| Wellcare by Allwell | All Managed Medicare | $378 |
| Humana | All Managed Medicare PPO | $378 |
| Elevance Health | HMO - Anthem Pathway Essentials | $408 |
| United Healthcare | ASO | $500 |
| Ambetter | All HMO Marketplace Plans | $611 |
| Caresource | All Government Medicaid HIP | $632 |
| Elevance Health | All Government Medicaid HIP | $632 |
| United Healthcare | All Managed Medicaid | $632 |
| Managed Health Services | All Government Medicaid | $632 |
| Elevance Health | All Managed Medicaid | $632 |
| Caresource | All Managed Medicaid | $632 |
| Managed Health Services | All Government Medicaid HIP | $632 |
| Elevance Health | All Traditional Plans | $725 |
| Elevance Health | All IUHP Employee Plans | $725 |
| Elevance Health | All PPO | $725 |
| Elevance Health | All HMO/POS | $725 |
| Cigna | HMO/POS - Arnett Hospital Plans | $725 |
| Aetna | POS - Cox Medical Plans | $725 |
| Sagamore Health Network/Cigna | PPO - NON-DRG | $725 |
| Aetna | HMO - Coventry Plans | $725 |
| Aetna | PPO - IN Preferred | $725 |
| Cigna | PPO - New Business | $725 |
| Sagamore Health Network/Cigna | PPO - DRG Plans | $725 |
| Encore Health Network | PPO/HMO/EPO - Combined/Encircle | $725 |
Inpatient
$941cash price (self-pay)
$3,315list price
$941–$2,984range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Self-Pay | Other - Self-Pay | $941 |
| SIHO Insurance Services | PPO - Union Health | $1,359 |
| Aetna | PPO - IN Preferred | $1,890 |
| Cigna | PPO - New Business | $1,890 |
| Aetna | POS - Cox Medical Plans | $1,890 |
| Community Health Direct | HMO - LaPorte Regional Plans | $1,956 |
| Parkview Health | HMO - Employee Plans | $2,049 |
| Unified Group Services | HMO | $2,055 |
| Aetna | HMO - Coventry Plans | $2,228 |
| Aetna | PPO/POS | $2,228 |
| Community Health Direct | HMO - ProHealth Plans | $2,321 |
| Lutheran Health Network | All Managed Care | $2,321 |
| Encore Health Network | PPO | $2,387 |
| Parkview Health | EPO | $2,390 |
| Sagamore Health Network/Cigna | PPO - NON-DRG | $2,466 |
| Naughton Insurance | All Managed Care | $2,486 |
| SIHO Insurance Services | HMO/POS Plans | $2,619 |
| Lutheran Preferred | All PPO Plans | $2,652 |
| Parkview Health | PPO | $2,732 |
| SIHO Insurance Services | All PPO Plans | $2,785 |
| Cofinity (PPOM) Network | All Managed Care | $2,818 |
| Multiplan | PPO - PHCS Private Healthcare Plans | $2,818 |
| Aetna | PPO - NAP | $2,867 |
| Aetna | PPO - First Health | $2,867 |
| Indiana Health Network (IHN) | All Managed Care | $2,884 |
| Community Health Alliance | PPO | $2,984 |
| Multiplan | PPO - Multiplan Plans | $2,984 |
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