CT abdomen and pelvis with contrast at MaineHealth - Memorial Hospital. CPT 74177.
What MaineHealth - Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 9, 2025.
Outpatient / ER
$2,277cash price (self-pay)
$2,277list price
$85.80–$2,140range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | MHACO Government | $194 |
| Anthem | Medicare Advantage | $311 |
| Wellcare | Medicare Advantage | $311 |
| Aetna | Medicare Advantage | $348 |
| Humana | Medicare Advantage | $348 |
| United Healthcare | Medicare Advantage | $348 |
| Aetna | MHACO Commercial | $402 |
| Aetna | HMO/PPO | $416 |
| Multiplan | Commercial | $525 |
| Community Health Options | Commercial | $535 |
| United Healthcare | Commercial | $553 |
| Harvard Pilgrim Healthcare | Commercial | $600 |
| Harvard Pilgrim Healthcare | Maine's Choice | $600 |
| Anthem | HMO/POS/PPO Pathway Enhanced | $896 |
| Cigna | Commercial | $1,917 |
Inpatient
$2,277cash price (self-pay)
$2,277list price
$1,817–$2,140range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | HMO/POS/PPO Pathway Enhanced | $1,817 |
| Community Health Options | Commercial | $1,821 |
| Harvard Pilgrim Healthcare | Maine's Choice | $1,908 |
| Cigna | Commercial | $1,917 |
| Aetna | HMO/PPO | $1,971 |
| Harvard Pilgrim Healthcare | Commercial | $2,120 |
| Multiplan | Commercial | $2,140 |
| United Healthcare | Commercial | $2,140 |
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