CT abdomen and pelvis with contrast at Northwest Health - Starke. CPT 74177.
What Northwest Health - Starke publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$937cash price (self-pay)
$3,471list price
$350–$3,263range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| One Call | One Call Care Diagnostics WC | $350 |
| NODE Tricare | NODE Tricare | $351 |
| NODE ChampVA | NODE ChampVA | $369 |
| Anthem | Anthem IN HIP | $395 |
| CareSource | CareSource Medicaid | $487 |
| 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 |
| IN Medicaid | IN Medicaid Non-Par | $632 |
| MHS | MHS HCC IN Medicaid | $632 |
| MHS | 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 |
| Anthem IN Work Comp | Anthem IN Work Comp | $633 |
| Lutheran | Lutheran Preferred | $937 |
| Self Pay | Self Pay | $937 |
| MedPartners | Lutheran Preferred CHS Employees | $1,163 |
| Anthem | Anthem IN Marketplace STLD | $1,200 |
| Anthem IN Healthsync | Anthem IN Healthsync | $1,230 |
| Physicians Health Plan | PHP Options | $1,434 |
| Anthem | Anthem IN HMO PPO TRAD | $1,500 |
| Alpha Baking | Alpha Baking | $1,562 |
| PHP | PHP Freedom Network | $2,089 |
| Encore | Encore Combined PPO | $2,256 |
| UHC Apa | UHC Apa | $2,433 |
| United Healthcare | UHC Core | $2,457 |
| MultiPlan Inc | MultiPlan Complementary | $2,777 |
Inpatient
$1,909cash price (self-pay)
$3,471list price
$1,163–$3,263range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| MedPartners | Lutheran Preferred CHS Employees | $1,163 |
| Self Pay | Self Pay | $1,909 |
| Encore | Encore Combined PPO | $2,256 |
| Cigna All | Cigna All | $2,881 |
| MultiPlan Inc | MultiPlan Complementary | $2,950 |
| Aetna | Aetna NAP | $3,002 |
| Coventry First Health | Coventry First Health | $3,002 |
| Encore | Encore | $3,020 |
| Lutheran Network | Lutheran Preferred Choice | $3,054 |
| Sagamore Health Network | Sagamore | $3,054 |
| Community Health Alliance | Community Health Alliance | $3,124 |
| MultiPlan Inc | MultiPlan Primary | $3,124 |
| PPOM | Cofinity | $3,263 |
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