CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 74177 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$372

about 1.0× the $356 Medicare rate · typically $282–$580

modeled estimate · not a bill or quote

What this hospital charges insurers

$318

Below the fair price — a good deal

about $54 under the fair price · 0.9× Medicare

Medicare pays $356 Fair price $372 This hospital $318 Cash price $1,261 Hospital's list price $4,121

How we calculate the fair BaseRate →

How this hospital compares to other NH hospitals

One of the lower prices — 6 of 8 other NH hospitals charge more for the same procedure.

Cheapest $212 Priciest $1,211

Black dot = this hospital, among the 9 NH hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, abdomen and pelvis (with contrast) is about $372 (about 1.0× the $356 Medicare rate). Mary Hitchcock Memorial Hospital charges insurers about $318, or about $1,261 in cash — below the fair price — a good deal. Located in Lebanon, NH.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$84 - $4,931	24%
Blue Cross Blue Shieldmajor	$84 - $5,595	24%
Aetnamajor	$81 - $5,586	23%
Cignamajor	$86 - $4,405	24%
Ambetter (Centene)	$88 - $860	25%
AmeriHealth	$47 - $728	13%
Harvard Pilgrim	$105 - $4,119	29%
MVP Health Care	$84 - $4,302	24%
Tufts Health Plan	$279 - $3,746	78%
WellCare	$87 - $416	24%
WellSense	$41 - $784	12%
+ 7 smaller / regional plans	$46 - $6,100

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,261), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 74177.

Insurance Before you use insurance

Call your insurance company to confirm Mary Hitchcock Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 74177.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Mary Hitchcock Memorial Hospital

Compare: CT scan, abdomen and pelvis (with contrast) at other NH hospitals

Insurance negotiated median for the same procedure, sorted lowest first.