MaineHealth - Memorial Hospital — CT scan prices
← Hospital overviewVerified from MaineHealth - Memorial Hospital’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
4 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| HC CT ABD & PELVIS W/ CONTRAST Outpatient | 74177 CPT | $2,277 | $2,277 | $774 – $2,140 | $1,685 | |
| HC CT ABD & PELVIS W/O CONTRAST Outpatient | 74176 CPT | $1,209 | $1,209 | $411 – $1,136 | $935 | |
| HC CT SCAN HEAD CONTRAST Outpatient | 70460 CPT | $1,987 | $1,987 | $603 – $1,868 | — | |
| HC CT THORAX W/ CONTRAST Outpatient | 71260 CPT | $2,482 | $2,482 | $603 – $2,333 | $2,149 |