CT abdomen and pelvis with contrast at Franklin Memorial Hospital. CPT 74177.
What Franklin Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 9, 2025.
Outpatient / ER
$1,961cash price (self-pay)
$1,961list price
$85.80–$1,844range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | MHACO Government | $194 |
| Aetna | Medicare Advantage | $303 |
| Anthem | Medicare Advantage | $348 |
| United Healthcare | Medicare Advantage | $348 |
| Wellcare | Medicare Advantage | $348 |
| Harvard Pilgrim Healthcare | Commercial | $386 |
| Harvard Pilgrim Healthcare | Maine's Choice | $386 |
| Aetna | MHACO Commercial | $402 |
| Aetna | HMO/PPO | $416 |
| Multiplan | Commercial | $470 |
| United Healthcare | Commercial | $494 |
| Community Health Options | Commercial | $535 |
| Anthem | HMO/POS/PPO Pathway Enhanced | $588 |
| Cigna | Commercial | $1,642 |
Inpatient
$1,961cash price (self-pay)
$1,961list price
$1,486–$1,844range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Harvard Pilgrim Healthcare | Maine's Choice | $1,486 |
| Aetna | HMO/PPO | $1,496 |
| Cigna | Commercial | $1,642 |
| Harvard Pilgrim Healthcare | Commercial | $1,652 |
| Community Health Options | Commercial | $1,710 |
| United Healthcare | Commercial | $1,749 |
| Multiplan | Commercial | $1,844 |
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