CT abdomen and pelvis with contrast at Lehigh Valley Hospital - Dickson City. CPT 74177.
What Lehigh Valley Hospital - Dickson City publishes for this service, straight from its standard-charges file, last updated July 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$289–$2,068range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | Healthspring | $289 |
| Geisinger | Managed Medicaid | $289 |
| United Healthcare | Managed Medicaid | $303 |
| United Healthcare | Chip | $303 |
| Jefferson Health Partners | All Products | $340 |
| Aetna | Managed Medicaid | $342 |
| Highmark Blue Shield | Medicare Advantage | $347 |
| Jefferson Health Partners | Managed Medicaid | $355 |
| Pa Health & Wellness | Managed Medicaid | $355 |
| Aetna | Medicare Advantage | $357 |
| Amerihealth | Medicare Advantage | $357 |
| Devoted Health | Medicare Advantage | $357 |
| Geisinger | Medicare Advantage | $357 |
| Humana | Medicare Advantage | $357 |
| Jefferson Health Partners | Medicare Advantage | $357 |
| Highmark Wholecare/Gateway | Managed Medicaid | $358 |
| Upmc | Medicare Advantage | $360 |
| Emblem | Medicare Advantage | $367 |
| Gateway | Medicare Advantage | $370 |
| Pa Health & Wellness (Allwell) | Medicare Advantage | $374 |
| Amerihealth Caritas | Managed Medicaid | $382 |
| Upmc | Snp | $429 |
| Upmc | Managed Medicaid | $442 |
| Highmark Blue Shield | Aca Narrow Network | $654 |
| Highmark Blue Shield | Tiered Products (Coalition) | $769 |
| Geisinger | All Products | $804 |
| Highmark Blue Shield | All Products | $855 |
| Highmark Blue Shield | Chip | $925 |
| Meshoppen Stone | All Products | $951 |
| Ambetter | All Products | $1,031 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.
All common services at Lehigh Valley Hospital - Dickson City