CT abdomen and pelvis with contrast at Mahnomen Health Center. CPT 74177.
What Mahnomen Health Center publishes for this service, straight from its standard-charges file, last updated July 16, 2026.
Outpatient / ER
$5,581cash price (self-pay)
$6,201list price
$357–$5,891range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Sanford Health Plan | Medicare Advantage | $357 |
| United Healthcare | Managed Medicaid | $375 |
| UCare Minnesota | Medicare Advantage | $375 |
| Medica | Minnesota Senior Health Options/Select Solution/Prime Solutio | $654 |
| Medica | Choice Care | $667 |
| Medica | Commercial | $1,014 |
| Blue Cross Blue Shield of Minnesota | Minnesota Health Care Programs ( | $1,745 |
| Medica | Medicare Advantage | $2,790 |
| United Healthcare | Medicare Advantage | $3,038 |
| United Healthcare | Commercial | $4,093 |
| Blue Cross Blue Shield of Minnesota | Blue Cross Blue Plus | $4,466 |
| Sanford Health Plan | Commercial | $5,891 |
Inpatient
$6,201cash price (self-pay)
$6,201list price
—range insurers pay
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