CT abdomen and pelvis with contrast at Northern Itasca Hospital District. CPT 74177.
What Northern Itasca Hospital District publishes for this service, straight from its standard-charges file, last updated September 15, 2026.
Outpatient / ER
$3,218cash price (self-pay)
$4,532list price
$2,240–$4,396range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid Minnesota | All plans | $2,240 |
| Aetna | Medicare Advantage | $2,576 |
| Blue Cross Blue Shield of MN | Medicare Advantage | $2,576 |
| Humana | Medicare Advantage | $2,576 |
| Medicare A MN J6 | All plans | $2,576 |
| United Healthcare | All commercial | $3,127 |
| Medica | All commercial | $3,925 |
| Aetna | All commercial | $4,396 |
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