CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: UPMC Hamot

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $1,736
Cash Discount Price: $6,946
vs. Medicare Baseline: 4.87x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at UPMC Hamot is $1,736. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,946. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.87x the Medicare baseline. Located in 201 State Street, Erie, PA.

Cash / Self-Pay

$6,946

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,736

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: $6,946 (1949%)

Insurance Median: $1,736 (487%)

Cash: $6,946 (1949% of Medicare)

Ins. Median: $1,736 (487% 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 487% of the Medicare baseline (a markup of 387%). 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
Blue Cross Blue Shield	$211 - $2,653	59%
Upmc Health Plan	$289 - $1,974	81%
UnitedHealthcare	$303 - $693	85%
Aetna	$316 - $8,103	89%
Geisinger	$366	103%
Highmark Wholecare (Prev Gateway)	$390 - $5,788	109%
Fidelis	$393	110%
Health Partners Plans (Jefferson Health Plan)	$397	111%
Wellcare	$405	114%
Amerihealth Caritas	$411 - $424	115%
Cigna	$424 - $4,630	119%
Pa Health & Wellness	$424 - $448	119%
Upmc Work Partners	$502	141%
Independent Health	$567 - $755	159%
Univera	$1,736 - $5,093	487%
Intergroup	$7,524 - $9,261	2111%
Multiplan	$8,103 - $9,261	2273%

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 $6,946.
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 Hamot 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.