CT abdomen and pelvis with contrast at Sanford Sheldon Medical Center. CPT 74177.
What Sanford Sheldon Medical Center publishes for this service, straight from its standard-charges file, last updated March 4, 2026.
Outpatient / ER
$4,469cash price (self-pay)
$5,586list price
$1,592–$5,027range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Sanford Health Plan Align | Medicare Replacement | $1,592 |
| Ucare | Medicare Replacement | $1,709 |
| Aetna | Medicare Replacement | $1,726 |
| Blue Cross Blue Shield of North Dakota | Medicare Replacement | $1,726 |
| Great Plains Medicare Advantage | Medicare Replacement | $1,726 |
| Health Partners | Medicare Replacement | $1,726 |
| United Healthcare | Medicare Replacement | $1,726 |
| Primewest | Medicare Replacement | $1,760 |
| Sanford Health Plan | Group Health/True | $2,993 |
| Sanford Health Plan | SD Exchange True | $2,993 |
| Security Health Plan | Commercial | $3,072 |
| Sanford Health Plan | Commercial/ND Pers | $3,521 |
| Sanford Health Plan | SD Exchange Commercial | $3,521 |
| Health Partners | State Employees | $3,687 |
| Health Partners | Commercial | $4,190 |
| Medica | Choice | $4,608 |
| United Healthcare | Commercial + Top 20 | $4,664 |
| Aetna | Commercial | $4,854 |
| Ucare | Commercial | $4,908 |
| Medica | Elect | $4,927 |
| First Choice Health Network | Commercial | $5,027 |
| Healthez | Commercial | $5,027 |
| Multiplan | Commercial | $5,027 |
Inpatient
$4,469cash price (self-pay)
$5,586list price
$2,793–$5,027range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellmark | HMO | $2,793 |
| Wellmark | PPO | $2,905 |
| Sanford Health Plan | Group Health/True | $2,993 |
| Sanford Health Plan | SD Exchange True | $2,993 |
| Security Health Plan | Commercial | $3,072 |
| Sanford Health Plan | Commercial/ND Pers | $3,521 |
| Sanford Health Plan | SD Exchange Commercial | $3,521 |
| Health Partners | State Employees | $3,687 |
| Health Partners | Commercial | $4,190 |
| Medica | Choice | $4,608 |
| United Healthcare | Commercial + Top 20 | $4,664 |
| Aetna | Commercial | $4,854 |
| Ucare | Commercial | $4,908 |
| Medica | Elect | $4,927 |
| First Choice Health Network | Commercial | $5,027 |
| Healthez | Commercial | $5,027 |
| Multiplan | Commercial | $5,027 |
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