CT abdomen and pelvis with contrast at CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Macungie. CPT 74177.
What CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Macungie publishes for this service, straight from its standard-charges file, last updated July 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$302–$2,159range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | Healthspring | $302 |
| Geisinger | Managed Medicaid | $329 |
| Capital Blue Cross | Medicare Advantage | $355 |
| Jefferson Health Partners | All Products | $355 |
| Jefferson Health Partners | Managed Medicaid | $355 |
| Pa Health & Wellness | Managed Medicaid | $355 |
| Highmark Wholecare/Gateway | Managed Medicaid | $358 |
| Humana | Medicare Advantage | $358 |
| Highmark Blue Shield | Medicare Advantage | $362 |
| Geisinger | Medicare Advantage | $365 |
| Aetna | Medicare Advantage | $373 |
| Amerihealth | Medicare Advantage | $373 |
| Jefferson Health Partners | Medicare Advantage | $373 |
| Upmc | Medicare Advantage | $376 |
| Aetna | Managed Medicaid | $382 |
| Amerihealth Caritas | Managed Medicaid | $382 |
| Emblem | Medicare Advantage | $383 |
| Gateway | Medicare Advantage | $387 |
| Pa Health & Wellness (Allwell) | Medicare Advantage | $390 |
| Upmc | Managed Medicaid | $442 |
| Upmc | Snp | $448 |
| Capital Blue Cross | Chip | $812 |
| Geisinger | Marketplace | $862 |
| Meshoppen Stone | All Products | $993 |
| Highmark Blue Shield | Chip | $1,004 |
| Highmark Blue Shield | All Products | $1,004 |
| Highmark Blue Shield | Tiered Products (Coalition) | $1,004 |
| Highmark Blue Shield | Aca Narrow Network | $1,004 |
| Cigna | All Products | $1,064 |
| Ambetter | All Products | $1,076 |
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All common services at CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Macungie