CT abdomen and pelvis with contrast at Norton Clark Hospital. CPT 74177.
What Norton Clark Hospital publishes for this service, straight from its standard-charges file, last updated June 3, 2026.
Outpatient / ER
$785cash price (self-pay)
$5,608list price
$162–$4,907range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Blue Cross Blue Shield | Managed Medicaid | $162 |
| CareSource Indiana Healthy Indiana Plan (HIP) | Managed Medicaid | $162 |
| Managed Health Services (MHS) Hoosier Care Connect | Managed Medicaid | $162 |
| Managed Health Services (MHS) Hoosier Healthwise (HHW) | Managed Medic | $162 |
| Humana | Managed Medicaid | $162 |
| CareSource Indiana Hoosier Healthwise (HHW) | Managed Medicaid | $167 |
| United Healthcare | Managed Medicaid | $167 |
| Mdwise Hoosier Healthwise (HHW) | Managed Medicaid | $170 |
| Molina Healthcare of Indiana | Managed Medicaid | $172 |
| Managed Health Services (MHS) Healthy Indiana Plan (HIP) | Managed Med | $374 |
| Anthem Blue Cross Blue Shield | Medicare Advantage | $374 |
| United Healthcare | VACCN | $374 |
| MDwise Health Indiana Plan (HIP) | Managed Medicaid | $374 |
| Molina Healthcare of Indiana | Medicare Advantage | $385 |
| CommuniCare Advantage | Medicare Advantage | $385 |
| Molina Healthcare of Indiana | Dual Medicare-Medicaid | $385 |
| Aetna | Medicare Advantage | $385 |
| Managed Health Services (MHS) | Medicare Advantage | $393 |
| United Healthcare | Commercial | $457 |
| Anthem Blue Cross Blue Shield of Indiana | Exchange/Pathway Essentials | $495 |
| Anthem Blue Cross Blue Shield | HMO/PPO/Traditional | $495 |
| Managed Health Services (MHS) | Commercial Exchange | $542 |
| Cigna | Commercial | $2,285 |
| Anthem Blue Cross Blue Shield | Medicare Select | $2,584 |
| Aetna | Commercial | $2,653 |
| PPOM | Commercial | $4,907 |
Inpatient
$785cash price (self-pay)
$5,608list price
$2,413–$4,907range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Blue Cross Blue Shield | HMO/PPO/Traditional | $2,413 |
| Anthem Blue Cross Blue Shield of Indiana | Exchange/Pathway Essentials | $2,413 |
| PPOM | Commercial | $4,907 |
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