CT abdomen and pelvis with contrast at Essentia Health-Virginia. CPT 74177.
What Essentia Health-Virginia publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$2,389cash price (self-pay)
$3,804list price
$350–$3,439range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Advocare/Security Health | Medicare | $350 |
| BLUE CROSS MEDICARE ADVANTAGE CORE | Medicare | $350 |
| Freedom Blue PPO | Medicare | $350 |
| HEALTHPARTNERS CARE MSHO / MCR ADV | Medicare | $350 |
| IMCARE MSHO PCC PRIME | Medicare | $350 |
| IMCARE MSHO REF REQ | Medicare | $350 |
| MEDICA ADVANTAGE SOLUTIONS | Medicare | $350 |
| MEDICA MSHO/Dual Solutions | Medicare | $350 |
| MEDICA PRIME SOLUTION GROUP | Medicare | $350 |
| MEDICARE ADV PFFS | Medicare | $350 |
| ND VA ADMINISTRATION | Medicare | $350 |
| OUT OF STATE BCBS MEDICARE ADVANTAGE | Medicare | $350 |
| PRIMEWEST MSHO | Medicare | $350 |
| Platinum Blue/Vantage Blue | Medicare | $350 |
| SECURE BLUE MSHO | Medicare | $350 |
| SECURITY HEALTH MEDICARE | Medicare | $350 |
| UBH COST PLAN | Medicare | $350 |
| Itasca Med Care | Medicaid | $357 |
| Primewest | Medicaid | $371 |
| Medica Access | Medicaid | $875 |
| Sanford HealthPlan | Commercial | $1,132 |
| Sanford HealthPlan | Commercial-NDPERS | $1,132 |
| HealthPartners CARE PMAP | Medicaid | $1,514 |
| MN BCBS Commercial | BCBS MN | $1,539 |
| BCBS MN | Medicaid | $1,786 |
| Blue Plus PMAP PCC PRIME | Medicaid | $1,786 |
| BCBS Mn | Shp | $1,787 |
| Medica Uplan | Commercial | $2,423 |
| Medica | Commercial-FI | $2,423 |
| Medica | Commercial-SI | $2,556 |
Inpatient
$2,389cash price (self-pay)
$3,804list price
$1,632–$3,427range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Sanford HealthPlan | Commercial-NDPERS | $1,632 |
| Sanford HealthPlan | Commercial | $1,718 |
| BCBS Mn | Shp | $1,787 |
| Ucare | Commercial | $2,503 |
| BCBS MN | Medicaid | $2,554 |
| Blue Plus PMAP PCC PRIME | Medicaid | $2,554 |
| WEA | Commercial-Narrow Network | $2,739 |
| HealthPartners | SHP | $2,864 |
| BCBS WI | Commercial | $2,891 |
| Security Health | Commercial | $2,929 |
| WEA | Commercial | $2,929 |
| America's PPO | Commercial | $2,948 |
| WPS | Commercial | $3,157 |
| Aetna First Health | Commercial | $3,233 |
| MN BCBS Commercial | BCBS MN | $3,233 |
| Cigna | Commercial | $3,427 |
| HealthPartners PCC Prime | Commercial | $3,427 |
| HealthPartners | Commercial | $3,427 |
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