CT abdomen and pelvis with contrast at Jefferson Einstein Montgomery Hospital. CPT 74177.
What Jefferson Einstein Montgomery Hospital publishes for this service, straight from its standard-charges file, last updated September 15, 2026.
Outpatient / ER
$419cash price (self-pay)
—list price
$251–$1,441range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| PA | Health | $251 |
| Geisinger | Medicaid | $261 |
| United | Healthcare | $287 |
| Jefferson | Health | $336 |
| Health | Partners | $340 |
| US | Family | $345 |
| IBC | Medicare | $354 |
| Humana | Medicare | $354 |
| Trinity | Health | $354 |
| Devoted | Health | $354 |
| United | Medicare | $366 |
| Cigna | Medicare | $368 |
| Keystone | First | $370 |
| UPMC | Medicare | $371 |
| Provider | Partners | $371 |
| Highmark | Medicare | $371 |
| Aetna | Medicare | $375 |
| Advantra | Medicare | $375 |
| Highmark | Wholecare | $382 |
| United | Group | $382 |
| Wellcare | Medicare | $389 |
| Geisinger | Medicare | $407 |
| UPMC | Medicaid | $458 |
| IBC | Proactive | $495 |
| Ambetter | Commercial | $513 |
| Ibc | HMO | $523 |
| Cigna | Commercial | $674 |
| IBC | Indemnity | $694 |
| Aetna | Commercial | $697 |
| Ibc | PPO | $726 |
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All common services at Jefferson Einstein Montgomery Hospital