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New Hampshire rates for HCPCS 74177

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

Facilitymedian $123 · 10th–90th $81$3,5480%20%40%10th90th$123Professionalmedian $229 · 10th–90th $83$6460%5%10%10th90th$229$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
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$81.28 / $123.03 / $3,548.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $371.54 / $831.76
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$72.44 / $91.20 / $229.09
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$213.80 / $269.15 / $758.58
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $245.47 / $1,000.00
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$67.61 / $107.15 / $275.42
Ambetter
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $724.44 / $1,023.29
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$83.18 / $194.98 / $275.42
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$218.78 / $501.19 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $575.44 / $954.99
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$95.50 / $138.04 / $257.04
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$257.04 / $416.87 / $691.83
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $537.03 / $831.76
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$97.72 / $151.36 / $223.87
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$251.19 / $389.05 / $575.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $489.78 / $1,047.13
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$91.20 / $134.90 / $263.03
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$251.19 / $354.81 / $707.95
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$64.57 / $70.79 / $83.18