CT abdomen and pelvis with contrast at Southern New Hampshire Medical Center. CPT 74177.
What Southern New Hampshire Medical Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$1,699cash price (self-pay)
$4,592list price
$381–$2,623range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Managed Care Plan | $381 |
| Bcbs | Anthem Pathway Individual Other Commerical | $388 |
| Wellsense | Medicare Managed Care Plan | $396 |
| Cigna | Medicare Managed Care Plan | $400 |
| Ambetter | Exchange | $495 |
| Bcbs | Anthem Pathway Small Group Exchange | $607 |
| Bcbs | Hpn Other Commercial Plan | $1,289 |
| Tufts | Hmo/Pos | $1,406 |
| Bcbs | Anthem Hmo/Pos | $1,417 |
| Aetna | All Commercial Plans | $1,765 |
| Tufts | Ppo | $2,237 |
| Bcbs | Anthem Ppo | $2,427 |
| Cigna | All Commercial Plans | $2,623 |
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All common services at Southern New Hampshire Medical Center