CT abdomen and pelvis with contrast at Northwest Health - Porter. CPT 74177.
What Northwest Health - Porter publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$3,300cash price (self-pay)
$12,221list price
$327–$10,266range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Veterans Eval Services | Veterans Eval Services | $329 |
| One Call | One Call Care Diagnostics WC | $350 |
| NODE Tricare | NODE Tricare | $351 |
| Align Network | Align Network | $591 |
| Anthem | Anthem IN Medicaid | $632 |
| CareSource | Caresource HHW IN Medicaid | $632 |
| CareSource | CareSource IN HIP | $632 |
| Humana PathWays IN Medicaid | Humana PathWays IN Medicaid | $632 |
| Indiana Medicaid | IN Medicaid | $632 |
| Indiana Medicaid Non Par | IN Medicaid Non Par | $632 |
| MHS | MHS HCC IN Medicaid | $632 |
| Managed Health Services | MHS HHW IN Medicaid | $632 |
| Managed Health Services | MHS IN HIP | $632 |
| UHC | UHC HCC IN Medicaid | $632 |
| UHC PathWays IN Medicaid | UHC PathWays IN Medicaid | $632 |
| Encore PPO | Encore Combined PPO | $788 |
| Aetna | Aetna HMO/POS | $945 |
| United Healthcare | UHC APA | $1,078 |
| United Healthcare | UHC PPO | $1,295 |
| First Health Coventry | First Health | $1,338 |
| Lutheran Preferred | Lutheran Preferred Exclusive Plus | $2,115 |
| Lutheran Preferred | Lutheran Preferred Fixed 2 | $2,115 |
| Lutheran Preferred CHS Employees | Lutheran Preferred CHS Employees | $2,933 |
| Self Pay | Self Pay | $3,300 |
| Cigna | Cigna ALL | $3,397 |
| Physicians Health Plan | PHP Options | $4,683 |
| PHP Freedom | PHP Freedom Network | $5,049 |
| Sagamore Health Network | Sagamore Indiana Financial | $5,402 |
| Aetna | Aetna PPO | $5,903 |
| Sagamore Health Network | Sagamore Anthem Groups | $6,013 |
Inpatient
$4,400cash price (self-pay)
$12,221list price
$2,933–$10,266range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Lutheran Preferred CHS Employees | Lutheran Preferred CHS Employees | $2,933 |
| Cigna | Cigna ALL | $3,397 |
| Self Pay | Self Pay | $4,400 |
| Physicians Health Plan | PHP Options | $4,683 |
| PHP Freedom | PHP Freedom Network | $5,049 |
| Sagamore Health Network | Sagamore Indiana Financial | $5,402 |
| Sagamore Health Network | Sagamore Anthem Groups | $6,013 |
| Aetna | Aetna PPO | $6,196 |
| Sagamore Health Network | Sagamore Select Plus | $7,235 |
| Lutheran Preferred | Lutheran Preferred Choice | $7,333 |
| Southeastem Indiana Health Operations | SIHO Outside Counties | $8,555 |
| Prime Health | PRIME HEALTH SERVICES | $9,166 |
| Prime Health | Prime Health Services Auto | $9,166 |
| Southeastem Indiana Health Operations | SIHO Inside Counties | $9,166 |
| Encore Health | Encore Health PPO | $9,777 |
| Multiplan/PHCS | Multiplan Complementary | $10,266 |
| Multiplan/PHCS | PHCS Savility Primary Network | $10,266 |
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