CT abdomen and pelvis with contrast at UPMC Hanover. CPT 74177.
What UPMC Hanover publishes for this service, straight from its standard-charges file, last updated March 6, 2026.
Outpatient / ER
$2,986cash price (self-pay)
$4,976list price
$252–$4,329range 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 Wholecare (prev Gateway) | Medicaid | $334 |
| Highmark BCBS of PA | Medicare | $338 |
| Humana | Medicare | $341 |
| UPMC Health Plan | Managed Medicaid | $342 |
| Aetna | Medicare | $356 |
| Cigna | Medicare | $358 |
| Geisinger | Medicare | $358 |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $358 |
| United Healthcare | Medicare | $365 |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advant | $368 |
| Geisinger | Medicaid/CHIP | $383 |
| PA Health & Wellness | PA Medicaid HMO | $448 |
| UPMC Work Partners | Workers Comp | $525 |
| Keystone Autism Services | ACAP | $546 |
| Capital Blue Cross | Medicare Advantage | $945 |
| Keystone Health Plan | Medicare Advantage | $945 |
| Highmark BCBS of PA | Medicaid | $1,132 |
| Highmark BCBS of PA | Commercial | $1,214 |
| Prime Net | Managed Medicare | $1,378 |
| Aetna | ACO | $1,833 |
| Cigna | Commercial | $2,007 |
| Aetna | Commercial | $2,349 |
| Geisinger | Commercial | $3,258 |
| Capital Blue Cross | CHIP | $3,382 |
| Capital Blue Cross | Commercial | $3,382 |
| Keystone Health Plan | Commercial | $3,382 |
| UPMC Health Plan | Commercial | $3,483 |
Inpatient
$2,986cash price (self-pay)
$4,976list price
$3,594–$4,329range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Geisinger | Commercial | $3,594 |
| CareFirst | Commercial | $4,230 |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $4,230 |
| Wellspan Population Health | Commercial | $4,329 |
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