CT abdomen and pelvis with contrast at St Lukes Hospital Carbon Campus. CPT 74177.
What St Lukes Hospital Carbon Campus publishes for this service, straight from its standard-charges file, last updated February 27, 2026.
Outpatient / ER
$8,785cash price (self-pay)
$10,584list price
$303–$3,694range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Highmark Wholecare | Medicaid | $303 |
| Geisinger | Medicaid/CHIP | $311 |
| AmeriHealth Caritas | Medicaid | $316 |
| UPMC Health Plan | Medicaid | $316 |
| Capital Blue Cross | Medicare | $355 |
| Highmark | Medicare Advantage | $355 |
| Highmark | Freedom Blue Medicare Advantage | $359 |
| Aetna | Medicare | $363 |
| Geisinger | Medicare | $363 |
| Humana | Medicare | $370 |
| UPMC Health Plan | Medicare Advantage | $373 |
| Jefferson Health Plan | CHIP/Medicaid | $379 |
| United Healthcare | Medicare Advantage | $384 |
| Highmark | Commercial/Special Care | $998 |
| Independence Blue Cross | AmeriHealth | $1,080 |
| Capital Blue Cross | Commercial | $1,803 |
| Oscar | Commercial | $2,747 |
| Cigna | Commercial | $2,897 |
| UPMC Health Plan | Commercial | $2,901 |
| Geisinger | Commercial | $2,975 |
| United Healthcare | Commercial | $3,059 |
| Aetna | Medical Rental | $3,641 |
| Aetna | Commercial | $3,694 |
Inpatient
$8,785cash price (self-pay)
$10,584list price
$2,747–$2,976range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Oscar | Commercial | $2,747 |
| UPMC Health Plan | Commercial | $2,894 |
| Geisinger | Commercial | $2,976 |
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