CT abdomen and pelvis with contrast at St. Mary Medical Center. CPT 74177.
What St. Mary Medical Center publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$2,891cash price (self-pay)
$4,448list price
$222–$4,226range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Medicaid | Aetna Better Health Medicaid | $279 |
| Upmc Medicaid Advantage | Upmc Health Plan Medicaid | $289 |
| Jefferson Health Plans Medicaid | Health Partners Medicaid | $301 |
| Highmark Wholecare Medicaid | Gateway Health Medicaid | $303 |
| United Healthcare Medicaid | UHC Community Plan Medicaid | $317 |
| Blue Cross - Pa (Independence) Medicare Advantage | Independence Blue | $376 |
| Cigna Medicare Advantage | Cigna Healthspring Medicare Advantage | $380 |
| Align Senior Care | Ally Align Health | $384 |
| Devoted Health Medicare Advantage | Devoted Health Medicare Advantage | $386 |
| Keystone First Chc Medicare Advantage | Keystone First Medicare Advant | $387 |
| Allwell Pa Health & Wellness Medicaid Advantage | Pa Health And Wellne | $395 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $398 |
| Jefferson Health Plans Medicare | Health Partners Medicare Advantage | $399 |
| Health Partners Medicare Advantage | Health Partners Medicare Advantag | $399 |
| Allwell Medicare Advantage | Pa Health & Wellness Medicare Advantage | $406 |
| Allwell Pa Health & Wellness Medicare Advantage | Pa Health & Wellness | $406 |
| Highmark Wholecare Medicare Advantage | Highmark Wholecare Medicare Ad | $433 |
| Upmc Medicare Advantage | Upmc Health Plan Medicare Advantage | $433 |
| Coventry Medicare Advantage | Coventry Advantra Medicare Advantage | $451 |
| Health America Advantra | Health America Medicare Advantage | $451 |
| Keystone First | Keystone Medicaid | $463 |
| Keystone First Chip | Keystone Medicaid | $463 |
| Keystone First Chc Medicaid | Keystone Medicaid | $463 |
| Ambetter | Ambetter Marketplace | $671 |
| Oscar Medicare Advantage | Oscar Medicare Advantage | $677 |
| Prime Healthcare | Prime Healthcare | $677 |
| Oscar | Oscar Medicare Advantage | $677 |
| Jefferson Health Plan Commercial | Jefferson Health Plan | $685 |
| Homestead Health Plans Woods Center | Homestead Health Plan Medicare A | $733 |
| Reedman Toll | Reedman Toll Management Group | $846 |
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