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CT Scan of Abdomen and Pelvis, Without IV Contrast

New Hampshire rates for HCPCS 74176

A detailed cross-sectional imaging exam of the abdomen and pelvis using X-rays, performed without contrast dye injected into a vein. A contrast drink may still be given to outline the bowel. It gives a clear picture of the organs, bones and other structures in this area and is used to investigate pain, injury, or suspected abnormalities.

Rates data updated July 2026.

Facilitymedian $78 · 10th–90th $78$1580%50%90th$78Professionalmedian $195 · 10th–90th $91$4270%10%10th90th$195$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
26 · Professional part
Typical Low
$77.62
Median
$77.62
Typical High
$158.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$204.17
Typical High
$489.78
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$64.57
Median
$89.13
Typical High
$208.93
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$91.20
Median
$125.89
Typical High
$281.84
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$151.36
Ambetter
Setting
Professional
Modifier
26 · Professional part
Typical Low
$64.57
Median
$102.33
Typical High
$263.03
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$446.68
Typical High
$616.60
Anthem BCBS
Setting
Professional
Modifier
26 · Professional part
Typical Low
$79.43
Median
$190.55
Typical High
$269.15
Anthem BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$102.33
Median
$245.47
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$371.54
Typical High
$588.84
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$91.20
Median
$141.25
Typical High
$245.47
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$125.89
Median
$223.87
Typical High
$363.08
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$309.03
Typical High
$489.78
Harvard Pilgrim
Setting
Professional
Modifier
26 · Professional part
Typical Low
$91.20
Median
$138.04
Typical High
$213.80
Harvard Pilgrim
Setting
Professional
Modifier
TC · Technical part
Typical Low
$120.23
Median
$186.21
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$302.00
Typical High
$660.69
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$87.10
Median
$128.82
Typical High
$251.19
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$120.23
Median
$173.78
Typical High
$338.84
Well Sense
Setting
Facility
Modifier
26 · Professional part
Typical Low
$61.66
Median
$67.61
Typical High
$79.43