CT abdomen and pelvis with contrast at Thomas Jefferson University Hospital. CPT 74177.
What Thomas Jefferson University Hospital publishes for this service, straight from its standard-charges file, last updated September 15, 2026.
Outpatient / ER
$412cash price (self-pay)
$3,296list price
$193–$2,103range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Jefferson Health Plan Medicaid | JCC001_JCC002 Caid MCO CHIP | $256 |
| PA Health and Wellness CHC | JCC001_JCC002 CHC | $296 |
| Jefferson Health Plan ACA QHP Exchange | JCC001_JCC002 Commercial Exch | $306 |
| Geisinger Medicaid | JCC001 JCC002 Caid MCO | $308 |
| Point of Comfort Refugee Resettlement | Commercial | $323 |
| VA_Champus_Tricare | JCC001_JCC002 Military | $323 |
| St Agnes | Medicare | $323 |
| Horizon Medicare Blue | JCC001_JCC002 Medicare | $323 |
| Innovage | JCC001_JCC002 Medicare | $323 |
| IBC Medicare | JCC001 Medicare | $323 |
| Inspira Life | JCC001_JCC002 Medicare | $323 |
| Optum VA CCN | JCC001_JCC002 VA CCN | $323 |
| Jefferson Health Plan Medicare | JCC001_JCC002 Medicare | $329 |
| Humana Medicare | JCC001_JCC002 Medicare | $329 |
| United Healthcare Medicare | JCC001_JCC002 AARP | $329 |
| United Healthcare Medicare | Medicare ISNP | $329 |
| Keystone First VIP Choice | JCC001 Medicare | $329 |
| Cigna HealthSpring Medicare Adv | JCC001_JCC002 Medicare | $335 |
| Devoted Health Participation | JCC001_JCC002 Medicare | $339 |
| UPMC Medicare Advantage | JCC001_JCC002 Medicare | $339 |
| Highmark Medicare Advantage | JCC001_JCC002 Medicare | $339 |
| Aetna Medicare Adv | JCC001_JCC002 Medicare | $342 |
| UPMC CHC Medicaid | JCC001 JCC002 CHC | $345 |
| Provider Partners Health Plan | JCC001_JCC002 Medicare | $345 |
| United Healthcare Medicare | Medicare Group Retiree | $348 |
| PA Health and Wellness Medicare | JCC001_JCC002 Medicare | $355 |
| Geisinger Medicare Advantage | JCC001_JCC002 Medicare | $371 |
| Perennial | JCC001_JCC002 Medicare | $374 |
| Highmark Wholecare Gateway | JCC001_JCC002 Medicare | $377 |
| IBC Employee Benefit | JCC001_JCC002 Commercial | $403 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.