CT abdomen and pelvis with contrast at Sanford Luverne Medical Center. CPT 74177.
What Sanford Luverne Medical Center publishes for this service, straight from its standard-charges file, last updated March 4, 2026.
Outpatient / ER
$4,336cash price (self-pay)
$5,420list price
$375–$5,127range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Ucare | Medicaid Managed Care | $375 |
| Blue Cross Blue Shield of Minnesota | PMAP | $608 |
| Blue Cross Blue Shield of Minnesota | Commercial/Federal | $1,216 |
| Blue Cross Blue Shield of Minnesota | State Employees | $1,216 |
| Sanford Health Plan Align | Medicare Replacement | $1,908 |
| Ucare | Medicare Replacement | $2,043 |
| Aetna | Medicare Replacement | $2,065 |
| Blue Cross Blue Shield of Minnesota | Medicare Replacement | $2,065 |
| Great Plains Medicare Advantage | Medicare Replacement | $2,065 |
| Health Partners | Medicare Replacement | $2,065 |
| United Healthcare | Medicare Replacement | $2,065 |
| Primewest | Medicare Replacement | $2,106 |
| Primewest | Medicaid Managed Care | $2,564 |
| Sanford Health Plan | Group Health/True | $2,904 |
| Sanford Health Plan | SD Exchange True | $2,904 |
| Security Health Plan | Commercial | $2,981 |
| Sanford Health Plan | Commercial/ND Pers | $3,416 |
| Sanford Health Plan | SD Exchange Commercial | $3,416 |
| Health Partners | State Employees | $3,734 |
| Health Partners | Commercial | $4,336 |
| United Healthcare | Commercial + Top 20 | $4,526 |
| Aetna | Commercial | $4,710 |
| Ucare | Commercial | $4,762 |
| Medica | Choice | $4,764 |
| Cigna | Commercial | $4,878 |
| First Choice Health Network | Commercial | $4,878 |
| Healthez | Commercial | $4,878 |
| Multiplan | Commercial | $4,878 |
| Medica | Elect | $5,127 |
Inpatient
$4,336cash price (self-pay)
$5,420list price
$2,904–$5,127range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Sanford Health Plan | Group Health/True | $2,904 |
| Sanford Health Plan | SD Exchange True | $2,904 |
| Security Health Plan | Commercial | $2,981 |
| Sanford Health Plan | Commercial/ND Pers | $3,416 |
| Sanford Health Plan | SD Exchange Commercial | $3,416 |
| Health Partners | State Employees | $3,734 |
| Health Partners | Commercial | $4,336 |
| Blue Cross Blue Shield of Minnesota | State Employees | $4,434 |
| United Healthcare | Commercial + Top 20 | $4,526 |
| Aetna | Commercial | $4,710 |
| Ucare | Commercial | $4,762 |
| Medica | Choice | $4,791 |
| Cigna | Commercial | $4,878 |
| First Choice Health Network | Commercial | $4,878 |
| Healthez | Commercial | $4,878 |
| Multiplan | Commercial | $4,878 |
| Medica | Elect | $5,127 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.