CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: New London Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $412
Cash Discount Price: $1,919
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at New London Hospital is $412. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,919. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.16x the Medicare baseline. Located in 273 County Road, New London, NH.

Cash / Self-Pay

$1,919

Average discount available for prompt cash payment at this facility.

Insurance Median

$412

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)

Cash / Self-Pay: $1,919 (538%)

Insurance Median: $412 (116%)

Cash: $1,919 (538% of Medicare)

Ins. Median: $412 (116% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Granite State Health Plan	$47 - $2,120	13%
Wellsense Health Plan	$47 - $1,848	13%
Amerihealth Caritas Nh	$48 - $2,140	13%
Blue Cross Blue Shield	$84 - $3,326	24%
Martin'S Point Generations Advantage	$84 - $1,848	24%
Martin'S Point Health Care	$84 - $2,886	24%
UnitedHealthcare	$84 - $3,284	24%
Wellcare Health Plans	$86 - $1,848	24%
Aetna	$96 - $3,629	27%
Harvard Pilgrim Health Care Of Ne	$99 - $2,995	28%
Ambetter / Centene	$109 - $1,848	31%
Cigna	$115 - $3,899	32%
Tufts Health Plan	$2,903 - $3,023	814%
Coventry	$3,969	1114%
Multiplan	$3,990	1119%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,919.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 74177.

Insurance In-Network Protection Plan

Contact your insurance company to confirm New London Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 74177.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.