CT abdomen and pelvis with contrast at Westfield Memorial Hospital. CPT 74177.
What Westfield Memorial Hospital publishes for this service, straight from its standard-charges file, last updated April 14, 2026.
Outpatient / ER
$53.46cash price (self-pay)
$3,884list price
$70.54–$811range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Univera | Univera Essential Plan | $182 |
| Univera | Univera Healthy New York | $182 |
| Univera | Univera Medicare | $225 |
| Highmark | Highmark Together Blue | $252 |
| Univera | Univera Commercial | $264 |
| Highmark | Highmark Blue High Performance | $305 |
| United Healthcare | United Healthcare Medicaid | $308 |
| Highmark | Highmark Community Blue | $336 |
| Highmark | Highmark Connect Blue | $336 |
| Highmark | Highmark Indemnity | $336 |
| Highmark | Highmark Managed Care | $336 |
| Highmark | Highmark My Blue Access | $336 |
| Highmark | Highmark My Direct Blue | $336 |
| Highmark | Highmark Performance Blue | $336 |
| Highmark | Highmark Social Mission Indemnity | $336 |
| Highmark | Highmark Social Mission Managed Care | $336 |
| Cigna | Cigna Commercial | $346 |
| Geisinger | Geisinger CHIP | $365 |
| Geisinger | Geisinger Medicaid HC | $365 |
| Highmark | Highmark Community Blue Medicare PPO | $389 |
| Highmark | Highmark Complete Blue Medicare | $389 |
| Highmark | Highmark Freedom Blue | $393 |
| Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Me | $395 |
| Jefferson Health Plans | Jefferson Health Plans | $403 |
| American Health Plans | American Health Plans Medicare | $423 |
| United Healthcare | United Healthcare Of OH Medicaid | $426 |
| Amerihealth | Amerihealth Medicaid CHC | $434 |
| Amerihealth | Amerihealth Medicaid HC | $434 |
| United Healthcare | United Healthcare Commercial | $435 |
| Devoted Medicare | Devoted Health Medicare Advantage | $435 |
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