CT abdomen and pelvis with contrast at Sanford Worthington Medical Center. CPT 74177.
What Sanford Worthington Medical Center publishes for this service, straight from its standard-charges file, last updated March 4, 2026.
Outpatient / ER
$4,128cash price (self-pay)
$5,160list price
$283–$4,927range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross Blue Shield of Minnesota | PMAP | $283 |
| Sanford Health Plan Align | Medicare Replacement | $333 |
| Ucare | Medicare Replacement | $358 |
| Aetna | Medicare Replacement | $361 |
| Blue Cross Blue Shield of Minnesota | Medicare Replacement | $361 |
| Great Plains Medicare Advantage | Medicare Replacement | $361 |
| Health Partners | Medicare Replacement | $361 |
| United Healthcare | Medicare Replacement | $361 |
| Primewest | Medicare Replacement | $368 |
| Primewest | Medicaid Managed Care | $393 |
| Ucare | Medicaid Managed Care | $393 |
| Blue Cross Blue Shield of Minnesota | Commercial/Federal | $1,047 |
| Sanford Health Plan | Group Health/True | $2,000 |
| Sanford Health Plan | SD Exchange True | $2,000 |
| Blue Cross Blue Shield of Minnesota | State Employees | $2,322 |
| Sanford Health Plan | Commercial/ND Pers | $2,353 |
| Sanford Health Plan | SD Exchange Commercial | $2,353 |
| Security Health Plan | Commercial | $2,838 |
| Health Partners | State Employees | $3,178 |
| Health Partners | Commercial | $3,663 |
| Ucare | Commercial | $4,030 |
| Aetna | Commercial | $4,231 |
| United Healthcare | Commercial + Top 20 | $4,308 |
| Medica | Choice | $4,602 |
| First Choice Health Network | Commercial | $4,644 |
| Healthez | Commercial | $4,644 |
| Multiplan | Commercial | $4,644 |
| Medica | Elect | $4,927 |
Inpatient
$4,128cash price (self-pay)
$5,160list price
$2,000–$4,927range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Sanford Health Plan | Group Health/True | $2,000 |
| Sanford Health Plan | SD Exchange True | $2,000 |
| Sanford Health Plan | Commercial/ND Pers | $2,353 |
| Sanford Health Plan | SD Exchange Commercial | $2,353 |
| Security Health Plan | Commercial | $2,838 |
| Ucare | Commercial | $4,030 |
| Aetna | Commercial | $4,231 |
| United Healthcare | Commercial + Top 20 | $4,308 |
| Medica | Choice | $4,602 |
| First Choice Health Network | Commercial | $4,644 |
| Healthez | Commercial | $4,644 |
| Multiplan | Commercial | $4,644 |
| Medica | Elect | $4,927 |
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