CT abdomen and pelvis with contrast at Lehigh Valley Hospital - Schuylkill S. Jackson Street. CPT 74177.
What Lehigh Valley Hospital - Schuylkill S. Jackson Street publishes for this service, straight from its standard-charges file, last updated July 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$300–$2,172range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Managed Medicaid | $300 |
| Cigna | Healthspring | $303 |
| United Healthcare | Chip | $311 |
| United Healthcare | Managed Medicaid | $311 |
| Geisinger | Managed Medicaid | $313 |
| Jefferson Health Partners | Managed Medicaid | $355 |
| Pa Health & Wellness | Managed Medicaid | $355 |
| Capital Blue Cross | Medicare Advantage | $357 |
| Jefferson Health Partners | All Products | $357 |
| Highmark Wholecare/Gateway | Managed Medicaid | $358 |
| Geisinger | Medicare Advantage | $364 |
| Highmark Blue Shield | Medicare Advantage | $364 |
| Aetna | Medicare Advantage | $375 |
| Amerihealth | Medicare Advantage | $375 |
| Devoted Health | Medicare Advantage | $375 |
| Humana | Medicare Advantage | $375 |
| Jefferson Health Partners | Medicare Advantage | $375 |
| Upmc | Medicare Advantage | $378 |
| Amerihealth Caritas | Managed Medicaid | $382 |
| Emblem | Medicare Advantage | $385 |
| Gateway | Medicare Advantage | $389 |
| Pa Health & Wellness (Allwell) | Medicare Advantage | $393 |
| Upmc | Managed Medicaid | $442 |
| Upmc | Snp | $451 |
| Highmark Blue Shield | Chip | $851 |
| Geisinger | All Products | $903 |
| Meshoppen Stone | All Products | $999 |
| Highmark Blue Shield | Aca Narrow Network | $1,033 |
| Highmark Blue Shield | Tiered Products (Coalition) | $1,035 |
| Cigna | All Products | $1,064 |
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All common services at Lehigh Valley Hospital - Schuylkill S. Jackson Street