CT abdomen and pelvis with contrast at Methodist Hospitals Northlake Campus. CPT 74177.
What Methodist Hospitals Northlake Campus publishes for this service, straight from its standard-charges file, last updated April 16, 2026.
Outpatient / ER
$7,288cash price (self-pay)
$10,412list price
$367–$10,744range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicare | Medicare | $367 |
| Anthem | Medicare Advantage | $367 |
| Aetna | Medicare Advantage | $367 |
| Humana | Medicare Advantage | $367 |
| United Heathcare | Medicare Advantage | $367 |
| Zing | Medicare Advantage | $375 |
| United Healthcare | Navigate and Core payer | $532 |
| Anthem | Pathway Essentials | $551 |
| United Healthcare | HMO_and_PPO_Contracted_Plans | $572 |
| CareSource Maketplace | CareSource | $606 |
| Indiana Medicaid | Traditional | $632 |
| Anthem | Indiana HMO Medicaid | $632 |
| Managed Health Services | Indiana HMO Medicaid | $632 |
| CareSource | Indiana HMO Medicaid | $632 |
| United Healthcare | Indiana HMO Medicaid | $632 |
| Humana | Indiana HMO Medicaid | $632 |
| Aetna | HMO_and_PPO_Contracted_Plans | $727 |
| Ambetter | Ambetter HealthPlan | $735 |
| Anthem BCBS | Individual On Exchange | $978 |
| Physicians Health Plan of Northern Indiana | PHP | $1,102 |
| MagnaCare | MagnaCare | $1,745 |
| Cigna | HMO | $3,998 |
| Cigna | PPO | $4,342 |
| Encore | Combined | $6,247 |
| Aetna | FirstHealth | $6,487 |
| Phcs | PPO | $7,080 |
| Siho | PPO | $7,288 |
| Sagamore | PPO | $7,497 |
| Multiplan | PPO | $7,601 |
| Aetna | Coventry | $7,705 |
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