CT abdomen and pelvis with contrast at Sanford Wheaton. CPT 74177.
What Sanford Wheaton publishes for this service, straight from its standard-charges file, last updated March 4, 2026.
Outpatient / ER
$2,489cash price (self-pay)
$3,111list price
$375–$2,924range 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 |
| Sanford Health Plan Align | Medicare Replacement | $1,568 |
| Ucare | Medicare Replacement | $1,683 |
| Aetna | Medicare Replacement | $1,699 |
| Blue Cross Blue Shield of Minnesota | Medicare Replacement | $1,699 |
| Great Plains Medicare Advantage | Medicare Replacement | $1,699 |
| Health Partners | Medicare Replacement | $1,699 |
| United Healthcare | Medicare Replacement | $1,699 |
| Security Health Plan | Commercial | $1,711 |
| Primewest | Medicare Replacement | $1,731 |
| Primewest | Medicaid Managed Care | $1,882 |
| Blue Cross Blue Shield of North Dakota | Commercial | $2,141 |
| Sanford Health Plan | Group Health/True | $2,456 |
| Health Partners | Commercial | $2,520 |
| United Healthcare | Commercial + Top 20 | $2,598 |
| Aetna | Commercial | $2,703 |
| Ucare | Commercial | $2,733 |
| Medica | Choice | $2,735 |
| First Choice Health Network | Commercial | $2,800 |
| Healthez | Commercial | $2,800 |
| Multiplan | Commercial | $2,800 |
| Sanford Health Plan | Commercial/ND Pers/SD Exchange Commercial | $2,889 |
| Sanford Health Plan | SD Exchange True | $2,889 |
| Medica | Elect | $2,924 |
Inpatient
$2,489cash price (self-pay)
$3,111list price
$1,711–$2,943range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Security Health Plan | Commercial | $1,711 |
| Sanford Health Plan | Group Health/True | $2,456 |
| United Healthcare | Commercial + Top 20 | $2,598 |
| Aetna | Commercial | $2,703 |
| Ucare | Commercial | $2,733 |
| Medica | Choice | $2,750 |
| First Choice Health Network | Commercial | $2,800 |
| Healthez | Commercial | $2,800 |
| Multiplan | Commercial | $2,800 |
| Sanford Health Plan | Commercial/ND Pers/SD Exchange Commercial | $2,889 |
| Sanford Health Plan | SD Exchange True | $2,889 |
| Medica | Elect | $2,943 |
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