CT abdomen and pelvis with contrast at Mt. Ascutney Hospital and Health Center. CPT 74177.
What Mt. Ascutney Hospital and Health Center publishes for this service, straight from its standard-charges file.
Outpatient / ER
$4,350cash price (self-pay)
$5,438list price
$3,836–$5,166range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Health Plans of NH | Commercial | $3,836 |
| The Vermont Health Plan | Commercial | $3,943 |
| Blue Cross and Blue Shield of Vermont | Commercial | $4,840 |
| MVP Health Plan, Inc. | Commercial | $4,949 |
| Cigna Health and Life Insurance Company | Commercial | $5,057 |
| HPHC Insurance Company, Inc. | Commercial | $5,057 |
| Aetna | Commercial | $5,166 |
| United Healthcare Insurance Company | Commercial | $5,166 |
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All common services at Mt. Ascutney Hospital and Health Center