CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: UPMC St Margaret

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $2,430
  • Cash Discount Price: $5,264
  • vs. Medicare Baseline: 6.82x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at UPMC St Margaret is $2,430. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,264. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.82x the Medicare baseline. Located in 815 Freeport Road, Pittsburgh, PA.
Cash / Self-Pay
$5,264

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,430

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: $5,264 (1477%)
Insurance Median: $2,430 (682%)
Cash: $5,264 (1477% of Medicare)
Ins. Median: $2,430 (682% 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 682% of the Medicare baseline (a markup of 582%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
UnitedHealthcare $289 81%
Upmc Health Plan $289 - $1,100 81%
Aetna $358 - $3,509 100%
Highmark Wholecare (Prev Gateway) $368 - $4,386 103%
Pa Health & Wellness $368 - $448 103%
Amerihealth Caritas $411 115%
Upmc Work Partners $502 141%
Blue Cross Blue Shield $554 - $3,303 155%
Cigna $2,456 - $3,509 689%
Coventry/First Health $6,141 1723%
Private Health Care Systems $7,018 1969%
Selectcare $7,018 1969%
Humana $7,457 2092%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 815 Freeport Road, Pittsburgh, PA 15215
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals