CT abdomen and pelvis with contrast at Glacial Ridge Health System. CPT 74177.
What Glacial Ridge Health System publishes for this service, straight from its standard-charges file, last updated September 3, 2026.
Outpatient / ER
$396cash price (self-pay)
$2,561list price
$57.26–$2,451range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medica Mcaid | Medica Mcaid | $282 |
| Triwest - All Plans | Triwest - All Plans | $536 |
| Medica Mcare Adv | Medica Mcare Adv | $553 |
| Medica Msho | Medica Msho | $553 |
| UHC Mcare Adv | UHC Mcare Adv | $553 |
| BCBS Mcare Adv | BCBS Mcare Adv | $553 |
| UHC Mcaid | UHC Mcaid | $604 |
| Health Partners Mcaid | Health Partners Mcaid | $669 |
| BCBS Advantage | BCBS Advantage | $682 |
| BCBS Mhcp | BCBS Mhcp | $713 |
| BCBS Blue Plus - All Other Plans | BCBS Blue Plus - All Other Plans | $744 |
| Health Partners Mcare | Health Partners Mcare | $808 |
| Preferred One Pic/Pas | Preferred One Pic/Pas | $835 |
| Medica Comm - All Other Plans | Medica Comm - All Other Plans | $1,084 |
| UHC All Payer - All Other Plans | UHC All Payer - All Other Plans | $1,111 |
| Health Partners Comm - All Other Plans | Health Partners Comm - All Ot | $1,204 |
| Multiplan - All Plans | Multiplan - All Plans | $1,452 |
| Preferred One PPO - All Other Plans | Preferred One PPO - All Other Pl | $1,478 |
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