CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Alice Peck Day Memorial Hospital

Billing Code: 74177 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$689

about 1.9× the $356 Medicare rate · typically $213–$2,042

modeled estimate · not a bill or quote

What this hospital charges insurers

$958

Above the fair price

about $269 over the fair price · 2.7× Medicare

Medicare pays $356 Fair price $689 This hospital $958 Cash price $1,332 Hospital's list price $2,471

How we calculate the fair BaseRate →

How this hospital compares to other NH hospitals

On the higher side — 6 of 8 other NH hospitals charge less.

Cheapest $212 Priciest $1,211

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

A fair price for a CT scan, abdomen and pelvis (with contrast) is about $689 (about 1.9× the $356 Medicare rate). Alice Peck Day Memorial Hospital charges insurers about $958, or about $1,332 in cash — above the fair price. Located in Lebanon, NH.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $689. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$1,779	499%
Blue Cross Blue Shieldmajor	$1,222 - $2,199	343%
Aetnamajor	$2,224 - $2,347	624%
Cignamajor	$784 - $2,021	220%
Humanamajor	$2,570	721%
Ambetter (Centene)	$40	11%
Harvard Pilgrim	$1,537 - $2,142	431%
MVP Health Care	$2,249	631%
Tufts Health Plan	$1,812	508%
+ 4 smaller / regional plans	$41 - $832

Government programs also on file: Medicaid.

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 1,332), 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 Alice Peck Day 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 Alice Peck Day Memorial Hospital

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

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