CT abdomen and pelvis with contrast at WellSpan Evangelical Community Hospital. CPT 74177.
What WellSpan Evangelical Community Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$438cash price (self-pay)
$7,857list price
$289–$7,229range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UPMC_Medicaid | All_Plans | $289 |
| Amerihealth_Caritas_Medicaid | All_Plans | $311 |
| UPMC | UPMC_For_Kids | $318 |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $329 |
| Health_Partners_Medicaid | All_Plans | $329 |
| Geisinger_Medicaid | All_Plans | $341 |
| PA_Health_&_Wellness_Medicaid | All_Plans | $342 |
| Aetna_Advantra_Medicare | All_Plans | $344 |
| Aetna | All_Plans | $344 |
| Amerihealth_Medicare | All_Plans | $344 |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $344 |
| Devoted_Medicare | All_Plans | $344 |
| First_Health_Network | All_Plans | $344 |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $344 |
| Geisinger | All_Plans | $344 |
| Geisinger_Gold_Medicare | All_Plans | $344 |
| Humana_Medicare | All_Plans | $344 |
| Jefferson_Health_Medicare_Advantage | All_Plans | $344 |
| PA_Health_&_Wellness_Medicare | All_Plans | $344 |
| United_Medicaid | Community_Plan_For_Kids | $344 |
| UPMC_for_Life_Community_HealthChoices | UPMC_for_Life_Complete_Care | $344 |
| United_Medicare | ISNP_DSNP_Plans | $344 |
| Highmark | Higmark_Healthy_Kids | $345 |
| Performance_Blue | Blue_Cross_High_Performance_Network | $345 |
| Highmark | All_Other_Plans | $345 |
| Highmark_Medicare | All_Plans | $345 |
| Blue_Cross | Capital_Cares_4_kids | $1,346 |
| Blue_Cross | All_Other_Plans | $1,922 |
| United_Healthcare | All_Plans | $2,107 |
| UPMC | All_Plans | $7,229 |
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All common services at WellSpan Evangelical Community Hospital