go back

Maine rates for HCPCS 74177

Computed tomography, abdomen and pelvis; with contrast material(s)

Facilitymedian $120 · 10th–90th $100$6610%50%10th90th$120Professionalmedian $204 · 10th–90th $81$5370%10%20%10th90th$204$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$100.00 / $120.23 / $660.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $380.19 / $812.83
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$77.62 / $91.20 / $199.53
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$213.80 / $275.42 / $616.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $446.68 / $954.99
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $125.89 / $281.84
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$218.78 / $316.23 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $457.09 / $831.76
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$87.10 / $120.23 / $194.98
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$245.47 / $331.13 / $562.34
Community Health Options
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $416.87 / $588.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $457.09 / $851.14
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$102.33 / $128.82 / $239.88
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$263.03 / $331.13 / $616.60
Martin's Point
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$97.72 / $104.71 / $11,748.98
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $389.05 / $776.25
Martin's Point
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $112.20 / $194.98
Martin's Point
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$229.09 / $281.84 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $467.74 / $2,137.96
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$87.10 / $128.82 / $331.13
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$218.78 / $309.03 / $616.60