CT abdomen and pelvis with contrast at Penn Presbyterian Medical Center. CPT 74177.
What Penn Presbyterian Medical Center publishes for this service, straight from its standard-charges file, last updated March 19, 2026.
Outpatient / ER
$11,304cash price (self-pay)
$11,304list price
$193–$11,304range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Managed Medicaid Other | Managed Medicaid Other | $193 |
| PA Health and Wellness Medicaid | PA Health and Wellness Medicaid | $222 |
| Keystone Mercy Health Plan | Keystone Mercy Health Plan | $247 |
| PA Medical Assistance | Medicaid | $263 |
| UPMC | UPMC Medicaid | $288 |
| Keystone HMO Proactive | Keystone HMO Proactive | $348 |
| Independence Blue Cross | Keystone Health Plan East-IBC HMO | $348 |
| IBC Commercial HPN | IBC Commercial HPN | $360 |
| TriCare | TriCare | $367 |
| UnitedHealthcare Community (fka AmeriChoice MA) | UnitedHealthcare Com | $380 |
| US Family Health Plan | US Family Health Plan | $422 |
| Independence Blue Cross | Personal Choice-IBC PPO | $688 |
| UnitedHealthcare New Business | UnitedHealthcare New Business | $1,176 |
| UnitedHealthcare Non Options | UnitedHealthcare Non Options | $1,219 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-PPO | $1,892 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-Indemnity | $1,892 |
| Horizon NJ Health | Horizon NJ Health | $1,987 |
| PGM - Regie de l'assurance Maladie Quebec | PGM - Regie de lassurance | $2,600 |
| Preferred Health Care Eliance | Preferred Health Care Eliance | $2,826 |
| PGM - Kuwait Defense | PGM - Kuwait Defense | $3,956 |
| Qualcare | Qualcare | $4,296 |
| Independence Blue Cross/Traditional | IBC Traditional | $4,386 |
| Wissahickon Hospice | Wissahickon Hospice | $4,522 |
| Pgm - Chop | Pgm - Chop | $4,522 |
| Olympus | Olympus | $5,358 |
| URN-Cancer Resource Services | URN-Cancer Resource Services | $5,652 |
| PGM - Royal Embassy of Saudi Arabia | PGM - Royal Embassy of Saudi Ara | $6,782 |
| PGM - Ontario Ministry of Health and Long-Term Care (OHIP) | PGM - Ont | $7,348 |
| PGM - Embassy of Qatar | PGM - Embassy of Qatar | $7,348 |
| PGM - Embassy of the United Emirates/IPC | PGM - Embassy of the United | $7,913 |
Inpatient
$11,304cash price (self-pay)
$11,304list price
$1,910–$11,304range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Horizon NJ Health | Horizon NJ Health | $1,910 |
| PGM - Regie de l'assurance Maladie Quebec | PGM - Regie de lassurance | $2,600 |
| Preferred Health Care Eliance | Preferred Health Care Eliance | $2,826 |
| Devon | Devon Premier | $4,296 |
| Pgm - Chop | Pgm - Chop | $4,522 |
| Coventry | HealthAmerica/Coventry SEPA | $4,522 |
| PGM - Kuwait Defense | PGM - Kuwait Defense | $5,087 |
| HealthAmerica/Coventry | HealthAmerica/HealthAssurance | $5,539 |
| URN-Cancer Resource Services | URN-Cancer Resource Services | $5,652 |
| First Health Global | First Health Global | $5,652 |
| Coventry | Coventry of Delaware | $5,765 |
| PGM - Royal Embassy of Saudi Arabia | PGM - Royal Embassy of Saudi Ara | $6,782 |
| Health Net | Health Net | $6,782 |
| PGM - Ontario Ministry of Health and Long-Term Care (OHIP) | PGM - Ont | $7,348 |
| Preferred Care | Preferred Care | $9,043 |
| PGM - Kuwait Oil | PGM - Kuwait Oil | $9,043 |
| PGM - Kuwait Health Division | PGM - Kuwait Health Division | $9,043 |
| Intergroup | Intergroup | $9,043 |
| Humana Choice Care | Humana Choice Care | $9,043 |
| Health America/CCN | First Health / Coventry National | $9,043 |
| Devon Health Services Inc | Devon Health Services | $9,043 |
| UPMC | UPMC Medicaid | $11,304 |
| UnitedHealthcare Community (fka AmeriChoice MA) | UnitedHealthcare Com | $11,304 |
| United Behavioral Health | United Behavioral Health | $11,304 |
| Quest Behavioral Health | Quest Behavioral Health | $11,304 |
| Managed Medicaid Other | Managed Medicaid Other | $11,304 |
| Keystone Mercy Health Plan | Keystone Mercy Health Plan | $11,304 |
| International PFS | International PFS | $11,304 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-PPO | $11,304 |
| Horizon Blue Cross of New Jersey | Horizon Blue Cross of NJ-Indemnity | $11,304 |
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