CT abdomen and pelvis with contrast at WellSpan York Hospital. CPT 74177.
What WellSpan York Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$438cash price (self-pay)
$2,896list price
$241–$2,751range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UPMC_Medicaid | All_Plans | $241 |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $329 |
| Geisinger_Medicaid | All_Plans | $329 |
| Health_Partners_Medicaid | All_Other_Plans | $329 |
| PA_Health_&_Wellness_Medicaid | All_Plans | $329 |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $350 |
| Johns_Hopkins_HealthCare_Plan | Johns_Hopkins_US_Family_Health | $350 |
| Highmark_Medicare | All_Plans | $353 |
| Aetna_Advantra_Medicare | All_Plans | $360 |
| Aetna_Medicare | All_Plans | $360 |
| Geisinger_Gold_Medicare | All_Plans | $367 |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $369 |
| Amerihealth_Medicare | All_Plans | $369 |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $369 |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $369 |
| Amerihealth_Caritas_Medicaid | All_Plans | $374 |
| Jefferson_Health_Medicare_Advantage | All_Plans | $378 |
| PA_Health_&_Wellness_Medicare | All_Plans | $378 |
| Health_Partners_Medicaid | Kidz_Partners | $385 |
| WellSpan_Capital_Blue_Cross | All_Plans | $395 |
| Blue_Cross | Capital_Blue_Performance_PPO | $407 |
| Highmark | Higmark_Healthy_Kids | $525 |
| United_Medicaid | Community_Plan_For_Kids | $612 |
| Aetna_Better_Health_Kids | All_Plans | $895 |
| Highmark | My_Direct_Blue | $1,293 |
| Highmark | My_Priority_Blue_Flex | $1,293 |
| Highmark | Choice_Blue_PPO | $1,724 |
| Highmark | Performance_Blue | $1,724 |
| Highmark | Blue_Cross_High_Performance_Network | $1,724 |
| Blue_Cross | Capital_Cares_4_kids | $1,824 |
Inpatient
$438cash price (self-pay)
$2,896list price
$1,610–$2,751range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue_Cross | Capital_Blue_Performance_PPO | $1,610 |
| Blue_Cross | Capital_Cares_4_kids | $1,650 |
| Blue_Cross | All_Other_Plans | $2,356 |
| Aetna | All_Plans | $2,511 |
| First_Health_Network | All_Plans | $2,511 |
| Cigna | All_Plans | $2,585 |
| PHC | All_Plans | $2,606 |
| WellSpan_Capital_Blue_Cross | All_Plans | $2,664 |
| Johns_Hopkins_HealthCare_Plan | All_Other_Plans | $2,751 |
| UPMC | UPMC_For_Kids | $2,751 |
| UPMC | Employees_And_Dependents | $2,751 |
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