CT abdomen and pelvis with contrast at UPMC Memorial. CPT 74177.
What UPMC Memorial 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–$4,230range 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 Wholecare (prev Gateway) | Medicaid | $334 |
| UPMC Health Plan | Managed Medicaid | $342 |
| Aetna | Medicare | $357 |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $358 |
| Cigna | Medicare | $360 |
| Geisinger | Medicare | $360 |
| United Healthcare | Medicare | $366 |
| Geisinger | Medicaid/CHIP | $383 |
| Highmark BCBS of PA | Medicare | $447 |
| UPMC Work Partners | Workers Comp | $525 |
| Keystone Autism Services | ACAP | $548 |
| Capital Blue Cross | Medicare Advantage | $995 |
| Keystone Health Plan | Medicare Advantage | $995 |
| Prime Net | Managed Medicare | $1,013 |
| Highmark BCBS of PA | Medicaid | $1,134 |
| Highmark BCBS of PA | Commercial | $1,207 |
| Capital Blue Cross | CHIP | $1,575 |
| Capital Blue Cross | Commercial | $1,575 |
| Keystone Health Plan | Commercial | $1,575 |
| Cigna | Commercial | $2,007 |
| Prime Net | ACO/Legacy Commercial | $2,040 |
| Aetna | ACO | $2,055 |
| Prime Net | GateKeeper/NonGateKeeper | $2,374 |
| Aetna | Commercial | $2,388 |
| Geisinger | Commercial | $3,258 |
| UPMC Health Plan | Commercial | $3,483 |
| Wellspan Population Health | Commercial | $3,483 |
Inpatient
$2,986cash price (self-pay)
$4,976list price
$2,413–$4,230range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Prime Net | ACO/Legacy Commercial | $2,413 |
| Aetna | ACO | $2,428 |
| Prime Net | GateKeeper/NonGateKeeper | $2,806 |
| Aetna | Commercial | $2,826 |
| Geisinger | Commercial | $3,594 |
| Prime Net | FH-Medical Rental | $3,707 |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $4,230 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.