CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: UPMC Horizon

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $2,643
Cash Discount Price: $4,109
vs. Medicare Baseline: 7.42x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at UPMC Horizon is $2,643. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,109. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 7.42x the Medicare baseline. Located in 110 North Main Street, Greenville, PA.

Cash / Self-Pay

$4,109

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,643

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: $4,109 (1153%)

Insurance Median: $2,643 (742%)

Cash: $4,109 (1153% of Medicare)

Ins. Median: $2,643 (742% 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 742% of the Medicare baseline (a markup of 642%). 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
Aetna	$289 - $4,109	81%
Upmc Health Plan	$289 - $3,952	81%
UnitedHealthcare	$358 - $2,739	100%
Geisinger	$366	103%
Amerihealth Caritas	$368 - $411	103%
Cigna	$368 - $2,739	103%
Highmark Wholecare (Prev Gateway)	$368 - $390	103%
Pa Health & Wellness	$368 - $448	103%
Blue Cross Blue Shield	$395 - $3,123	111%
Health Partners Plans (Jefferson Health Plan)	$397	111%
Upmc Work Partners	$502	141%
Intergroup	$4,451	1249%
Coventry/First Health	$4,520	1268%
Health Coalition Partners	$4,794	1345%
Private Health Care Systems	$5,478	1537%
Prime Net	$5,615	1575%
Humana	$5,821	1633%

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 $4,109.
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 Horizon 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.