CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: UPMC Presbyterian Shadyside

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $4,846
Cash Discount Price: $6,200
vs. Medicare Baseline: 19.88x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at UPMC Presbyterian Shadyside is $4,846. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,200. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 19.88x the Medicare baseline. Located in 200 Lothrop Street, Pittsburgh, PA.

Cash / Self-Pay

$6,200

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,846

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $6,200 (2543%)

Insurance Median: $4,846 (1988%)

Cash: $6,200 (2543% of Medicare)

Ins. Median: $4,846 (1988% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 1988% of the Medicare baseline (a markup of 1888%). 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
UnitedHealthcare	$121 - $249	50%
Upmc Health Plan	$185 - $4,846	76%
Aetna	$219 - $2,584	90%
Amerihealth Caritas	$249 - $266	102%
Cigna	$249	102%
Highmark Wholecare (Prev Gateway)	$249 - $5,167	102%
Pa Health & Wellness	$249 - $287	102%
Health Partners Plans (Jefferson Health Plan)	$254	104%
Geisinger	$262	107%
Upmc Work Partners	$355	146%
Multiplan	$413 - $8,267	169%
Blue Cross Blue Shield	$479 - $3,180	196%
Preferred Healthcare System	$6,717	2755%
Coventry/First Health	$7,234	2968%
Fidelis	$7,750	3179%
Intergroup	$7,750 - $8,784	3179%
Health Coalition Partners	$8,267	3391%
Private Health Care Systems	$8,267	3391%
Selectcare	$8,267	3391%
Health Payors Organization	$8,784	3603%
Humana	$8,784	3603%

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 $6,200.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 74176.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Presbyterian Shadyside is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 74176.
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.