CT abdomen and pelvis with contrast at Grace Cottage Hospital. CPT 74177.
What Grace Cottage Hospital publishes for this service, straight from its standard-charges file.
Outpatient / ER
$4,231cash price (self-pay)
$5,289list price
$1,587–$5,289range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana | Medicare Advantage | $1,587 |
| MVP Health Plan | Commercial | $3,967 |
| United Healthcare Insurance Company | Commercial | $4,549 |
| Health Plans, Inc. | Commercial | $4,760 |
| Cigna Health and Life Insurance Company | Commercial | $5,025 |
| Aetna | Commercial | $5,130 |
| Blue Cross Blue Shield of Vermont | Commercial | $5,289 |
| Health New England | Commercial | $5,289 |
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