CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: UPMC Mercy

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $3,342
Cash Discount Price: $5,897
vs. Medicare Baseline: 9.38x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at UPMC Mercy is $3,342. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,897. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.38x the Medicare baseline. Located in 1400 Locust Street, Pittsburgh, PA.

Cash / Self-Pay

$5,897

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,342

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)

Cash / Self-Pay: $5,897 (1654%)

Insurance Median: $3,342 (938%)

Cash: $5,897 (1654% of Medicare)

Ins. Median: $3,342 (938% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 938% of the Medicare baseline (a markup of 838%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Upmc Health Plan	$284 - $3,952	80%
UnitedHealthcare	$303	85%
Aetna	$358 - $3,932	100%
Amerihealth Caritas	$368 - $416	103%
Highmark Wholecare (Prev Gateway)	$368 - $390	103%
Pa Health & Wellness	$368 - $448	103%
Blue Cross Blue Shield	$549 - $3,121	154%
Upmc Work Partners	$559	157%
Bravo	$2,457	689%
Cigna	$3,342 - $5,897	938%
Coventry/First Health	$4,325	1213%
Intergroup	$4,914 - $7,863	1379%
Private Health Care Systems	$7,372	2068%
American Healthcare Group	$7,863	2206%
National Provider Network	$8,060	2261%
Health Payors Organization	$8,846	2482%
Multiplan	$8,846	2482%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $5,897.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 74177.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Mercy is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 74177.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.