CT abdomen and pelvis with contrast at Lowell General Hospital. CPT 74177.
What Lowell General Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$2,532cash price (self-pay)
$3,617list price
$256–$3,617range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna [100001] | Hb Xr Aetna HMO PPO Lgh | $256 |
| Tufts Health Public Plan Connectorcare [100264] | Hb Xr Thpp Connector | $271 |
| Harvard Pilgrim Healthcare [100241] | Hb Xr Hphc Fully Insured Risk Hm | $348 |
| Harvard Pilgrim Healthcare [100241] | Hb Xr Hphc Fully Insured Referra | $348 |
| Harvard Pilgrim Healthcare [100241] | Hb Xr Hphc Self Insured Risk HMO | $348 |
| Blue Benefits Administrators [100267] | Hb Xr Bcbsma PPO Ppa Lgh | $704 |
| Blue Cross Of Ri [100266] | Hb Xr Bcbsma PPO Ppa Lgh | $704 |
| Blue Cross Of MA [100274] | Hb Xr Bcbsma PPO Ppa Lgh | $704 |
| Blue Cross Of MA [100274] | Hb Xr Bcbsma HMO Lgh | $704 |
| Blue Cross Of Nh [100265] | Hb Xr Bcbsma PPO Ppa Lgh | $704 |
| Allied Benefit Systems [100015] | Hb Xr Non-Contracted 35% Of Billed C | $1,266 |
| American Postal Workers [100089] | Hb Xr Non-Contracted 35% Of Billed | $1,266 |
| Amerihealth Caritas Nh [350007] | Hb Xr Non-Contracted 35% Of Billed C | $1,266 |
| Allied National Global Care [100107] | Hb Xr Non-Contracted 35% Of Bil | $1,266 |
| Carecentrix Alternate [100257] | Hb Xr Non-Contracted 35% Of Billed Ch | $1,266 |
| Avmed Health Plan [100247] | Hb Xr Non-Contracted 35% Of Billed Charge | $1,266 |
| Assurant [100020] | Hb Xr Non-Contracted 35% Of Billed Charges Lgh | $1,266 |
| Coresource [100285] | Hb Xr Non-Contracted 35% Of Billed Charges Lgh | $1,266 |
| Employee Benefit Management [100033] | Hb Xr Non-Contracted 35% Of Bil | $1,266 |
| Compsych [100027] | Hb Xr Non-Contracted 35% Of Billed Charges Lgh | $1,266 |
| Coverage Discovery [100306] | Hb Xr Non-Contracted 35% Of Billed Charg | $1,266 |
| Geha [100039] | Hb Xr Non-Contracted 35% Of Billed Charges Lgh | $1,266 |
| Eyemed [100290] | Hb Xr Non-Contracted 35% Of Billed Charges Lgh | $1,266 |
| D'Youville Senior Care [950003] | Hb Xr Non-Contracted 35% Of Billed C | $1,266 |
| First Health [100278] | Hb Xr Non-Contracted 35% Of Billed Charges Lgh | $1,266 |
| Generic Commercial [109999] | Hb Xr Non-Contracted 35% Of Billed Charg | $1,266 |
| Cigna [100009] | Hb Xr Thp PPO Lgh | $1,520 |
| Allaracare [100163] | Hb Xr Allaracare Lgh | $1,664 |
| Cigna [100009] | Hb Xr Cigna Lgh | $1,809 |
| Coventry [100010] | Hb Xr Coventry Lgh | $2,857 |
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