CT abdomen and pelvis with contrast at UPMC Northwest. CPT 74177.
What UPMC Northwest publishes for this service, straight from its standard-charges file, last updated March 6, 2026.
Outpatient / ER
$1,368cash price (self-pay)
$2,280list price
$289–$1,938range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UPMC Health Plan | Managed Medicaid | $289 |
| United Healthcare Community Plan for Families | Unison Kids | $303 |
| UPMC Health Plan | Managed Medicare | $309 |
| Aetna | Medicaid | $316 |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue | $340 |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $349 |
| Aetna | Medicare | $351 |
| United Healthcare | Unison Advantage Non Special Needs | $358 |
| Aetna of PA | Medicare | $358 |
| Highmark Wholecare (prev Gateway) | Medicare | $368 |
| AmeriHealth Caritas | Medicare | $368 |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advant | $368 |
| United Healthcare | Unison Advantage Special Needs | $375 |
| Highmark Wholecare (prev Gateway) | Medicaid | $390 |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $411 |
| PA Health & Wellness | PA Medicaid HMO | $448 |
| UPMC Work Partners | Workers Comp | $502 |
| Aetna | EBR ASO | $912 |
| Cigna | Commercial | $912 |
| UPMC Health Plan | Commercial | $1,097 |
| Aetna | EBR FI | $1,368 |
| Aetna | Neighborhood Network | $1,368 |
| Aetna | Home Depot Employer Group | $1,407 |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Ca | $1,424 |
| Aetna | NBR ASO/FI | $1,436 |
| Cigna | New Business ASO | $1,436 |
| InterGroup | PPO | $1,562 |
| Coventry/First Health | Commercial | $1,596 |
| Health Coalition Partners | PPO | $1,642 |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,754 |
Inpatient
$1,368cash price (self-pay)
$2,280list price
$912–$3,704range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | EBR ASO | $912 |
| Cigna | Commercial | $912 |
| Aetna | EBR FI | $1,322 |
| Aetna | Neighborhood Network | $1,414 |
| Aetna | Home Depot Employer Group | $1,452 |
| Aetna | NBR ASO/FI | $1,482 |
| Cigna | New Business ASO | $1,482 |
| Coventry/First Health | Commercial | $1,596 |
| Private Health Care Systems | PPO | $1,824 |
| Humana | Commercial | $1,938 |
| InterGroup | PPO | $2,593 |
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