CT abdomen and pelvis with contrast at Saint Joseph Regional Medical Center - Mishawaka. CPT 74177.
What Saint Joseph Regional Medical Center - Mishawaka publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$4,152cash price (self-pay)
$6,388list price
$191–$6,388range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina Medicaid | Medicaid | $191 |
| BCBS Medicare Advantage Generic | Anthem BCBS Healthy Medicare Advanta | $362 |
| Blue Cross - In (Anthem) Medicare Advantage | Anthem BCBS Medicare Adv | $362 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $362 |
| United Healthcare Medicare | United Healthcare Medicare Advantage | $369 |
| Pace-Trinity Health | Pace Trinity Health | $369 |
| Priority Health Medicare Advantage | Priority Health Medicare Advantag | $369 |
| Meridian Complete | Meridian Medicare Advantage | $369 |
| Medigold Medicare Advantage | Medigold Medicare Advantage | $376 |
| Physicians Health Plan Northern Indiana Health Insurance | Select Php | $572 |
| Caresource Medicaid | Caresource Medicaid | $632 |
| Managed Health Services - Indiana | Managed Health Services | $632 |
| Auxiant | Select Auxiant Pike Lumber Medicare Adv | $794 |
| Blue Cross - De (Highmark) | Anthem BCBS | $1,303 |
| Blue Cross - Dc (Carefirst) | Anthem BCBS | $1,303 |
| Blue Cross - NY (Excellus) | Anthem BCBS | $1,303 |
| Blue Cross - IL Alternate | Anthem BCBS | $1,303 |
| Blue Cross - Mi | Anthem BCBS | $1,303 |
| Blue Cross - Mn | Anthem BCBS | $1,303 |
| Blue Distinction Transplant | Anthem BCBS | $1,303 |
| Blue Cross - IL | Anthem BCBS | $1,303 |
| Blue Cross - Wi (Anthem) | Anthem BCBS | $1,303 |
| Blue Cross - Ia (Wellmark) | Anthem BCBS | $1,303 |
| Blue Cross - Co (Anthem) | Anthem BCBS | $1,303 |
| Blue Cross - Ct (Anthem) | Anthem BCBS | $1,303 |
| Blue Shield - NY Highmark Western | Anthem BCBS | $1,303 |
| Blue Cross - Nm | Anthem BCBS | $1,303 |
| Blue Cross - NY (Anthem) | Anthem BCBS | $1,303 |
| Blue Cross - Nh (Anthem) | Anthem BCBS | $1,303 |
| Blue Cross - Nj (Horizon) | Anthem BCBS | $1,303 |
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All common services at Saint Joseph Regional Medical Center - Mishawaka