CT abdomen and pelvis with contrast at Ascension Via Christi St. Francis (Ascension Via Christi Hospitals Wichita, Inc.). CPT 74177.
What Ascension Via Christi St. Francis (Ascension Via Christi Hospitals Wichita, Inc.) publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$330–$925range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Default - 100 Percent Of Medicare Rates | 1016_default - 100 Percent O | $330 |
| Medicare Advantage Coventry | 1339_medicare Advantage Coventry Outpati | $330 |
| Medicare Advantage Humana | 1340_medicare Advantage Humana Outpatient | $330 |
| Medicare Advantage Other | 1341_medicare Advantage Other Outpatient 20 | $330 |
| Saint Lukes Health Systems | 1005_saint Luke Health System Outpatient | $330 |
| Va | 1015_veterans Outpatient 20230101 | $330 |
| Vc Hope | 1342_medicare Advantage Vc Hope Outpatient 20250101 | $330 |
| Via Christi Research | 1006_via Christi Research Outpatient 20230101 | $330 |
| Aarp Medicare Replacement | 1336_medicare Advantage Aarp Outpatient 20 | $334 |
| Allwell Medicare | 1337_medicare Advantage Allwell Outpatient 20250101 | $337 |
| Medicare Advantage Blue Cross Blue Shield | 1338_medicare Advantage Bl | $337 |
| Medicare Advantage UHC | 1344_stks, Vwks Medicare Advantage United Hea | $337 |
| Corizon | 1004_corizon Outpatient Stks, Vwks 20230101 | $413 |
| Smarthealth | 1083_smarthealth Outpatient 20230101 | $462 |
| Ambetter Sunflower | 1003_ambetter Sunflower Outpatient 20230101 | $561 |
| Aetna: City Of Wichita | 643_aetna City Of Wichita Stks, Vwks 20200415 | $912 |
| United Healthcare Exchange | 1477_stks, Vwks United Healthcare Exchang | $925 |
Inpatient
—cash price (self-pay)
—list price
$330–$925range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Default - 100 Percent Of Medicare Rates | 1490_default - 100 Percent O | $330 |
| Medicare Advantage Humana | 1505_medicare Advantage Humana Inpatient V | $330 |
| Saint Lukes Health Systems | 1493_saint Lukes Health System Inpatient | $330 |
| Va | 1492_veterans Inpatient 20251001 | $330 |
| Vc Hope | 1502_medicare Advantage Vc Hope Inpatient 20251001 | $330 |
| Via Christi Research | 1495_via Christi Research Inpatient 20251001 | $330 |
| Aarp Medicare Replacement | 1507_medicare Advantage Aarp Inpatient 202 | $334 |
| Medicare Advantage Coventry | 1504_medicare Advantage Coventry Inpatie | $334 |
| Medicare Advantage Other | 1506_medicare Advantage Other Inpatient Vwk | $334 |
| Allwell Medicare | 1497_medicare Advantage Allwell Inpatient 20251001 | $337 |
| Medicare Advantage Blue Cross Blue Shield | 1498_medicare Advantage Bl | $337 |
| Medicare Advantage UHC | 1508_stks, Vwks Medicare Advantage United Hea | $337 |
| Corizon | 1494_corizon Inpatient Stks, Vwks 20251001 | $413 |
| Smarthealth | 1489_smarthealth Inpatient 20251001 | $462 |
| Ambetter Sunflower | 1491_ambetter Sunflower Inpatient 20251001 | $561 |
| United Healthcare Exchange | 1519_stks, Vwks United Healthcare Exchang | $925 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.