CT abdomen and pelvis with contrast at Jefferson Frankford Hospital. CPT 74177.
What Jefferson Frankford Hospital publishes for this service, straight from its standard-charges file, last updated September 15, 2026.
Outpatient / ER
$412cash price (self-pay)
$4,427list price
$193–$1,429range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Jefferson Health Plan Medicaid | JNE001_JNE002_JNE003 Caid MCO CHIP | $256 |
| PA Health and Wellness CHC | JNE001_JNE002_JNE003 CHC | $296 |
| Jefferson Health Plan ACA QHP Exchange | JNE002 JNE003 Commercial Exch | $306 |
| IBC Medicare | JNE002_JNE003 Medicare Focus | $306 |
| Geisinger Medicaid | JNE001_JNE002_JNE003 Caid | $308 |
| Innovage | JNE002_JNE003 Medicare | $323 |
| Point of Comfort Refugee Resettlement | Commercial | $323 |
| Provider Partners Health Plan | JNE002_JNE003 Medicare | $323 |
| VA_Champus_Tricare | JNE002_JNE003 Military | $323 |
| Horizon Medicare Blue | JNE002_JNE003 Medicare | $323 |
| Optum VA CCN | JNE002_JNE003 VA CCN | $323 |
| Highmark Medicare Advantage | JNE002_JNE003 Medicare | $323 |
| IBC Medicare | JNE002_JNE003 Medicare | $323 |
| St Agnes | Medicare | $323 |
| Inspira Life | JNE002_JNE003 Medicare | $323 |
| United Healthcare Medicare | JNE002_JNE003 AARP | $329 |
| Humana Medicare | Medicare | $329 |
| United Healthcare Medicare | Medicare ISNP | $329 |
| Jefferson Health Plan Medicare | JNE002_JNE003 Medicare | $329 |
| Cigna HealthSpring Medicare Adv | JNE002_JNE003 Medicare | $335 |
| Devoted Health Participation | JNE002_JNE003 Medicare | $339 |
| Aetna Medicare Adv | JNE002_JNE003 Medicare | $342 |
| Keystone First VIP Choice | JNE002_JNE003 Medicare | $344 |
| United Healthcare Medicare | Medicare Group Retiree | $348 |
| UPMC Medicare Advantage | JNE002_JNE003 Medicare | $355 |
| PA Health and Wellness Medicare | JNE002_JNE003 Medicare | $355 |
| Geisinger Medicare Advantage | JNE002_JNE003 Medicare | $371 |
| Perennial | JNE002_JNE003 Medicare | $374 |
| Highmark Wholecare Gateway | JNE002_JNE003 Medicare | $377 |
| Keystone First | JNE001_JNE_002_JNE003 Caid MCO | $390 |
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