CT abdomen and pelvis with contrast at Orange City Area Health System. CPT 74177.
What Orange City Area Health System publishes for this service, straight from its standard-charges file, last updated September 23, 2026.
Outpatient / ER
$212cash price (self-pay)
$1,198list price
$110–$2,067range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellmark HMO | Wellmark HMO | $604 |
| Wellmark PPO - All Other Plans | Wellmark PPO - All Other Plans | $671 |
| UHC All Payer-All Plans | UHC All Payer-All Plans | $1,014 |
| Health Partners Coordinated-All Other Plans | Health Partners Coordina | $1,049 |
| Midlands Choice-All Plans | Midlands Choice-All Plans | $1,053 |
| Health Partners Open | Health Partners Open | $1,059 |
| Sanford Health-All Plans | Sanford Health-All Plans | $1,095 |
| Avera-All Plans | Avera-All Plans | $1,099 |
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