CT abdomen and pelvis with contrast at Brattleboro Memorial Hospital. CPT 74177.
What Brattleboro Memorial Hospital publishes for this service, straight from its standard-charges file, last updated December 29, 2025.
Outpatient / ER
$4,098cash price (self-pay)
$5,878list price
$71.76–$5,724range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerihealth-Caritas | Managed Medicaid | $262 |
| New Hampshire Healthy Families | Managed Medicaid | $262 |
| Wellsense | Managed Medicaid | $262 |
| Anthem | Individual Pathway Exchange | $294 |
| Anthem | Medicare Advantage | $294 |
| Cigna | Medicare Advantage | $294 |
| Harvard Pilgrim Health Care | Medicare Advantage | $294 |
| Martin's Point | Medicare Advantage | $294 |
| MVP Healthcare | Medicare Advantage | $294 |
| New Hampshire Healthy Families (WellCare) | Medicare Advantage | $308 |
| Wellsense | Medicare Advantage | $314 |
| United Healthcare | Medicare Advantage | $343 |
| Humana | Medicare Advantage | $343 |
| Blue Cross Blue Shield of Vermont | Medicare Advantage | $349 |
| Anthem | Group Pathway Exchange | $411 |
| Anthem | Commercial | $644 |
| Tufts Health Plan | All Commercial Plans | $782 |
| Tufts Health Plan | Managed Medicaid | $782 |
| Tufts Health Plan | Medicare Advantage | $782 |
| Harvard Pilgrim Health Care | Exchange | $3,421 |
| Harvard Pilgrim Health Care | Elevate Health | $4,467 |
| Harvard Pilgrim Health Care | Commercial | $5,114 |
| Vermont Health Plan | All Plans | $5,240 |
| Blue Cross Blue Shield of Vermont | Commercial | $5,269 |
| MVP Healthcare | Commercial | $5,269 |
| Cigna | Commercial | $5,584 |
| United Healthcare | Commercial | $5,584 |
| MultiPlan | All Plans | $5,679 |
| Aetna | All Plans | $5,701 |
| Coventry | All Plans | $5,701 |
Inpatient
$4,098cash price (self-pay)
$5,878list price
$3,407–$5,724range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Harvard Pilgrim Health Care | Exchange | $3,421 |
| Harvard Pilgrim Health Care | Elevate Health | $4,467 |
| Tufts Health Plan | Managed Medicaid | $4,516 |
| Harvard Pilgrim Health Care | Commercial | $5,114 |
| Tufts Health Plan | Medicare Advantage | $5,120 |
| Vermont Health Plan | All Plans | $5,261 |
| Blue Cross Blue Shield of Vermont | Commercial | $5,290 |
| MVP Healthcare | Commercial | $5,290 |
| Tufts Health Plan | All Commercial Plans | $5,341 |
| Cigna | Commercial | $5,584 |
| United Healthcare | Commercial | $5,584 |
| Aetna | All Plans | $5,701 |
| Coventry | All Plans | $5,701 |
| Health New England | All Plans | $5,701 |
| MultiPlan | All Plans | $5,701 |
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