CT abdomen and pelvis with contrast at Calais Community Hospital. CPT 74177.
What Calais Community Hospital publishes for this service, straight from its standard-charges file.
Outpatient / ER
$652cash price (self-pay)
$2,723list price
$36.00–$4,210range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Medicare Advantage | $421 |
| United Healthcare | Medicare Advantage | $421 |
| Humana | Commercial | $1,144 |
| Martins Point Generation | Commercial | $1,144 |
| Wellcare | HMO | $1,144 |
| Partners Direct Health | Commercial | $1,579 |
| Anthem | Commercial | $2,233 |
| Aetna | Commercial | $2,341 |
| United Healthcare | PPO | $2,396 |
| Cigna | Commercial | $2,478 |
| Harvard Pilgrim | Commercial | $2,505 |
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