CT abdomen and pelvis with contrast at Altru Hospital Devils Lake. CPT 74177.
What Altru Hospital Devils Lake publishes for this service, straight from its standard-charges file, last updated March 1, 2026.
Outpatient / ER
$148cash price (self-pay)
$4,489list price
$134–$713range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Bcbs Blueplus Of Mn | Medicaid Managed Care Plan | $134 |
| Medica | Medicaid Managed Care Plan | $138 |
| Medica | Medicaid Managed Care Plan – Hmo | $138 |
| Medica | Medicare Managed Care Plan | $248 |
| Aetna | Medicare Managed Care Plan | $356 |
| Medica | All Commercial Plans | $405 |
| Sanford Health Plan | All Commercial Plans | $487 |
| Aetna | All Commercial Plans | $508 |
| Umr | All Commercial Plans | $628 |
| Bcbs Of Mn | All Commercial Plans | $647 |
| Bcbs Blueplus Of Mn | All Commercial Plans | $647 |
| United Healthcare | All Commercial Plans | $698 |
| Acuity Group | All Commercial Plans | $713 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.