CT abdomen and pelvis with contrast at Springfield Hospital. CPT 74177.
What Springfield Hospital publishes for this service, straight from its standard-charges file.
Outpatient / ER
$3,947cash price (self-pay)
$5,262list price
$2,000–$5,472range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Anthem Exchange | $2,000 |
| Anthem | Medicare Advantage | $2,000 |
| MVP Health Plan | Medicare Advantage | $2,000 |
| United Healthcare | Medicare Advantage | $2,000 |
| Wellsense | Medicare Advantage | $2,000 |
| Harvard Pilgrim Health Care | Medicare Advantage | $2,020 |
| WellCare | Medicare Advantage | $2,060 |
| Tufts Health Plan | Commercial | $3,233 |
| Anthem | Commercial | $3,527 |
| Cigna | Commercial | $3,694 |
| MVP Health Plan | Commercial | $4,052 |
| Harvard Pilgrim Health Care | Commercial | $4,354 |
| MultiPlan | Commercial | $4,367 |
| United Healthcare | Commercial | $4,736 |
| Aetna | Commercial | $4,999 |
| Coventry | Commercial | $4,999 |
| Beacon Health | Commercial | $5,262 |
| Blue Cross Blue Shield | Medicare Advantage | $5,262 |
| Manage Behavioral Health | Commercial | $5,262 |
| Martin's Point Healthcare | Tricare | $5,262 |
| Wellsense | Commercial | $5,262 |
| Cigna | Medicare Advantage | $5,472 |
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