CT abdomen and pelvis with contrast at Northern Light Acadia Hospital. CPT 74177.
What Northern Light Acadia Hospital publishes for this service, straight from its standard-charges file, last updated March 30, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$59.35–$673range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Optum | Commercial | $104 |
| Aetna | MCR Advantage | $195 |
| Anthem | MCR Advantage | $195 |
| Martin's Point | MCR Advantage | $195 |
| Optum | MCR Advantage | $199 |
| UHC | MCR Advantage | $199 |
| Wellcare | MCR Advantage | $199 |
| Anthem | Commercial | $233 |
| Aetna | Commercial | $241 |
| UHC | Commercial | $255 |
| Harvard | Commercial | $673 |
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