CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: UPMC Presbyterian Shadyside

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $6,943
Cash Discount Price: $8,885
vs. Medicare Baseline: 19.48x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at UPMC Presbyterian Shadyside is $6,943. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,885. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 19.48x the Medicare baseline. Located in 200 Lothrop Street, Pittsburgh, PA.

Cash / Self-Pay

$8,885

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,943

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: $8,885 (2493%)

Insurance Median: $6,943 (1948%)

Cash: $8,885 (2493% of Medicare)

Ins. Median: $6,943 (1948% 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 1948% of the Medicare baseline (a markup of 1848%). 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	$231 - $368	65%
Upmc Health Plan	$289 - $6,943	81%
Aetna	$342 - $3,702	96%
Amerihealth Caritas	$368 - $416	103%
Cigna	$368	103%
Highmark Wholecare (Prev Gateway)	$368 - $7,404	103%
Pa Health & Wellness	$368 - $448	103%
Health Partners Plans (Jefferson Health Plan)	$397	111%
Geisinger	$410	115%
Blue Cross Blue Shield	$554 - $3,677	155%
Upmc Work Partners	$559	157%
Multiplan	$650 - $11,846	182%
Preferred Healthcare System	$9,625	2700%
Coventry/First Health	$10,366	2908%
Fidelis	$11,106	3116%
Intergroup	$11,106 - $12,587	3116%
Health Coalition Partners	$11,846	3324%
Private Health Care Systems	$11,846	3324%
Selectcare	$11,846	3324%
Health Payors Organization	$12,587	3531%
Humana	$12,587	3531%

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 $8,885.
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 Presbyterian Shadyside 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.