CT abdomen and pelvis with contrast at UPMC Community Osteopathic. CPT 74177.
What UPMC Community Osteopathic publishes for this service, straight from its standard-charges file, last updated March 6, 2026.
Outpatient / ER
$338cash price (self-pay)
$2,770list price
$113–$4,230range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $252 |
| Premier Comp Solutions | Worker's Comp | $280 |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $334 |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue | $348 |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $353 |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $358 |
| Humana | Medicare | $362 |
| Aetna | Medicare | $366 |
| Cigna | Medicare | $369 |
| United Healthcare | Medicare | $376 |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advant | $379 |
| Geisinger | Medicaid/CHIP | $383 |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $448 |
| UPMC Work Partners | Workers Comp | $525 |
| Capital Blue Cross | Medicare Advantage | $554 |
| Keystone Health Plan | Medicare Advantage | $554 |
| Prime Net | Managed Medicare | $670 |
| Capital Blue Cross | CHIP | $1,237 |
| Capital Blue Cross | Commercial | $1,237 |
| Keystone Health Plan | Commercial | $1,237 |
| Aetna | ACO | $1,631 |
| Aetna | PEBTF ACO | $1,731 |
| InterGroup | PPO | $1,856 |
| Aetna | Commercial | $2,038 |
| Prime Net | FH-Medical Rental | $2,083 |
| Wellspan Population Health | Commercial | $2,354 |
| Highmark BCBS of PA | CHIP | $2,412 |
| Highmark BCBS of PA | Commercial | $2,412 |
| UPMC Health Plan | CHIP | $3,952 |
Inpatient
$338cash price (self-pay)
$2,770list price
$366–$4,230range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| InterGroup | PPO | $1,856 |
| Prime Net | FH-Medical Rental | $2,083 |
| Wellspan Population Health | Commercial | $2,354 |
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