CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: UPMC Somerset

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $368
Cash Discount Price: $1,662
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at UPMC Somerset is $368. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,662. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.03x the Medicare baseline. Located in 225 South Center Avenue, Somerset, PA.

Cash / Self-Pay

$1,662

Average discount available for prompt cash payment at this facility.

Insurance Median

$368

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: $1,662 (466%)

Insurance Median: $368 (103%)

Cash: $1,662 (466% of Medicare)

Ins. Median: $368 (103% 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.

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
Geisinger	$222 - $1,960	62%
UnitedHealthcare	$222 - $2,145	62%
Aetna	$225 - $1,990	63%
Multiplan	$282 - $3,234	79%
Upmc Health Plan	$289 - $3,952	81%
Amerihealth Caritas	$302 - $340	85%
Blue Cross Blue Shield	$337 - $639	95%
Highmark Wholecare (Prev Gateway)	$338 - $368	95%
Galaxy Health Plan	$366 - $3,234	103%
Humana	$422 - $3,732	118%
Upmc Work Partners	$502	141%

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 $1,662.
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 Somerset 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.