CT abdomen and pelvis with contrast at Melrose-Wakefield Hospital Campus. CPT 74177.
What Melrose-Wakefield Hospital Campus publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$1,291cash price (self-pay)
$1,844list price
$256–$1,948range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Meritain [100063] | Hb Xr Aetna HMO PPO Mwf | $256 |
| Health Plans Inc [100262] | Hb Xr Hphc HMO Mwf | $386 |
| Health Plans Inc [100262] | Hb Xr Hphc PPO Mwf | $386 |
| Health Safety Net [500011] | Hb Xr Hsn Er Bad Debt Mwf | $531 |
| Allied National Global Care [100107] | Hb Xr Non-Contracted 35% Of Bil | $645 |
| Allied Benefit Systems [100015] | Hb Xr Non-Contracted 35% Of Billed C | $645 |
| Assurant [100020] | Hb Xr Non-Contracted 35% Of Billed Charges Mwf | $645 |
| American Postal Workers [100089] | Hb Xr Non-Contracted 35% Of Billed | $645 |
| Avmed Health Plan [100247] | Hb Xr Non-Contracted 35% Of Billed Charge | $645 |
| Amerihealth Caritas Nh [350007] | Hb Xr Non-Contracted 35% Of Billed C | $645 |
| Benemax [100276] | Hb Xr Non-Contracted 35% Of Billed Charges Mwf | $645 |
| Carecentrix Alternate [100257] | Hb Xr Non-Contracted 35% Of Billed Ch | $645 |
| Compsych [100027] | Hb Xr Non-Contracted 35% Of Billed Charges Mwf | $645 |
| Coresource [100285] | Hb Xr Non-Contracted 35% Of Billed Charges Mwf | $645 |
| Generic Commercial [109999] | Hb Xr Non-Contracted 35% Of Billed Charg | $645 |
| First Health [100278] | Hb Xr Non-Contracted 35% Of Billed Charges Mwf | $645 |
| Care One [950007] | Hb Xr Non-Contracted 35% Of Billed Charges Mwf | $645 |
| Group And Pension Administrators [100043] | Hb Xr Non-Contracted 35% O | $645 |
| Coventry [100010] | Hb Xr Non-Contracted 35% Of Billed Charges Mwf | $645 |
| Coverage Discovery [100306] | Hb Xr Non-Contracted 35% Of Billed Charg | $645 |
| Lowell Comm Health Center [950009] | Hb Xr Non-Contracted 35% Of Bille | $645 |
| Mutual Of Omaha [100074] | Hb Xr Non-Contracted 35% Of Billed Charges | $645 |
| D'Youville Senior Care [950003] | Hb Xr Non-Contracted 35% Of Billed C | $645 |
| Tufts Health Public Plan Connectorcare [100264] | Hb Xr Thpp Connector | $830 |
| Cigna [100009] | Hb Xr Cigna Mwh | $922 |
| Cigna [100009] | Hb Xr Evernorth | $922 |
| Blue Cross Of MA [100274] | Hb Xr Bcbsma PPO Ppa Mwh | $1,050 |
| Blue Cross Of MA [100274] | Hb Xr Bcbsma HMO Mwh | $1,050 |
| Blue Benefits Administrators [100267] | Hb Xr Bcbsma PPO Ppa Mwh | $1,050 |
| Blue Cross Of Nh [100265] | Hb Xr Bcbsma PPO Ppa Mwh | $1,050 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.