CT abdomen and pelvis with contrast at Ortonville Area Health Services. CPT 74177.
What Ortonville Area Health Services publishes for this service, straight from its standard-charges file, last updated June 18, 2026.
Outpatient / ER
$3,026cash price (self-pay)
$3,560list price
$491–$3,453range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medica ChoiceCare/Accessibility Solution/MinnesotaCare | Commercial | $491 |
| Blue Cross Blue Shield | Managed Medicaid | $713 |
| Health Partners | Managed Medicaid | $1,780 |
| Medica | Medicare Advantage | $1,780 |
| Medica Minnesota Senior Health Options (MSHO)/Select Solution/Prime So | $1,780 |
| PrimeWest | Medicare Advantage | $1,780 |
| United Healthcare | Medicare Advantage | $1,780 |
| Ucare Health | HMO | $1,780 |
| United Healthcare | Managed Medicaid | $1,851 |
| Blue Cross Blue Shield | Commercial | $1,996 |
| Health Partners | Medicare Advantage | $2,136 |
| Sanford Health Plan | Commercial | $3,133 |
| United Healthcare | Commercial | $3,133 |
| Health Partners | Commercial | $3,176 |
| Medica Choice/Focus/IFB/MHPS/Care System | Commercial | $3,297 |
| MultiPlan | Commercial | $3,346 |
| America's Health System | PPO | $3,453 |
Inpatient
$3,026cash price (self-pay)
$3,560list price
$1,780–$3,453range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Partners | Managed Medicaid | $1,780 |
| Health Partners | Medicare Advantage | $2,136 |
| United Healthcare | Commercial | $3,133 |
| Health Partners | Commercial | $3,176 |
| Sanford Health Plan | Commercial | $3,275 |
| MultiPlan | Commercial | $3,346 |
| Blue Cross Blue Shield | Commercial | $3,382 |
| America's Health System | PPO | $3,453 |
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