CT abdomen and pelvis with contrast at Waldo County General Hospital. CPT 74177.
What Waldo County General Hospital publishes for this service, straight from its standard-charges file, last updated September 9, 2025.
Outpatient / ER
$4,782cash price (self-pay)
$4,782list price
$85.80–$4,505range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | MHACO Government | $194 |
| Anthem | Medicare Advantage | $303 |
| Aetna | Medicare Advantage | $348 |
| Humana | Medicare Advantage | $348 |
| United Healthcare | 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 | $4,505 |
Inpatient
$4,782cash price (self-pay)
$4,782list price
$4,008–$4,505range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Harvard Pilgrim Healthcare | Maine's Choice | $4,008 |
| Anthem | HMO/POS/PPO Pathway Enhanced | $4,255 |
| Aetna | HMO/PPO | $4,330 |
| Harvard Pilgrim Healthcare | Commercial | $4,453 |
| Multiplan | Commercial | $4,495 |
| Community Health Options | Commercial | $4,500 |
| United Healthcare | Commercial | $4,500 |
| Cigna | Commercial | $4,505 |
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