CT abdomen and pelvis with contrast at Witham Memorial Hospital. CPT 74177.
What Witham Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$4,807cash price (self-pay)
$6,867list price
$162–$17,168range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Medicaid | Anthem Medicaid | $162 |
| Anthem Mcr Adv | Anthem Mcr Adv | $369 |
| Anthem Hip | Anthem Hip | $369 |
| Mdwise Health In-All Plans | Mdwise Health In-All Plans | $369 |
| Caresource Mcr Adv | Caresource Mcr Adv | $376 |
| Aetna Mcr Adv | Aetna Mcr Adv | $380 |
| Caresource Indiana Marketplace-All Other Plans | Caresource Indiana MA | $701 |
| Anthem Exch | Anthem Exch | $4,258 |
| Anthem HMO | Anthem HMO | $4,731 |
| Anthem PPO | Anthem PPO | $4,731 |
| Aetna-All Other Plans | Aetna-All Other Plans | $5,082 |
| UHC-All Plans | UHC-All Plans | $5,356 |
| Anthem Trad-All Other Plans | Anthem Trad-All Other Plans | $5,407 |
| Phcs/Multiplan-All Plans | Phcs/Multiplan-All Plans | $6,249 |
| Sagamore-All Plans | Sagamore-All Plans | $6,318 |
| Humana Choice Care-All Plans | Humana Choice Care-All Plans | $6,386 |
| Beech Street-All Plans | Beech Street-All Plans | $6,455 |
| Encore-All Plans | Encore-All Plans | $6,524 |
| Mhs Comml Exch-All Plans | Mhs Comml Exch-All Plans | $17,168 |
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