CT abdomen and pelvis with contrast at Shriners Children's Boston. CPT 74177.
What Shriners Children's Boston publishes for this service, straight from its standard-charges file, last updated March 17, 2026.
Outpatient / ER
$4,176cash price (self-pay)
$4,176list price
$282–$817range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Centene NH Healthy Families | Mgd Medicaid | $282 |
| Well Sense Health Plan NH | Managed Medicaid | $282 |
| Cigna | Commercial | $306 |
| Aetna National | Commercial | $350 |
| United Healthcare | Nat | $382 |
| Aetna Better Health of Michigan | Managed Medicaid | $418 |
| Health New England | Medicare Advantage | $418 |
| Blue Cross Blue Shield of MA | Commercial | $431 |
| Harvard Pilgrim | Commercial | $483 |
| Sana Benefits | Commercial | $585 |
| Providence Health Plan | Commercial | $685 |
| Tufts Network Health Public Plan | Mgd. Medicaid | $817 |
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