CT abdomen and pelvis with contrast at Stephens Memorial Hospital. CPT 74177.
What Stephens Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 9, 2025.
Outpatient / ER
$1,838cash price (self-pay)
$1,838list price
$85.80–$1,783range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | MHACO Government | $194 |
| Anthem | Medicare Advantage | $303 |
| Aetna | Medicare Advantage | $348 |
| United Healthcare | Medicare Advantage | $348 |
| Humana | Medicare Advantage | $348 |
| Wellcare | Medicare Advantage | $362 |
| Aetna | MHACO Commercial | $402 |
| Aetna | HMO/PPO | $416 |
| Multiplan | Commercial | $470 |
| United Healthcare | Commercial | $494 |
| Community Health Options | Commercial | $535 |
| Harvard Pilgrim Healthcare | Commercial | $600 |
| Harvard Pilgrim Healthcare | Maine's Choice | $600 |
| Anthem | HMO/POS/PPO Pathway Enhanced | $920 |
| Cigna | Commercial | $1,713 |
Inpatient
$1,838cash price (self-pay)
$1,838list price
$1,604–$1,783range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Harvard Pilgrim Healthcare | Maine's Choice | $1,604 |
| Aetna | HMO/PPO | $1,680 |
| Cigna | Commercial | $1,713 |
| Anthem | HMO/POS/PPO Pathway Enhanced | $1,717 |
| Multiplan | Commercial | $1,727 |
| Community Health Options | Commercial | $1,746 |
| United Healthcare | Commercial | $1,764 |
| Harvard Pilgrim Healthcare | Commercial | $1,783 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.