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CT Scan of Abdomen and Pelvis, Without IV Contrast

South Dakota rates for HCPCS 74176

A detailed cross-sectional imaging exam of the abdomen and pelvis using X-rays, performed without contrast dye injected into a vein. A contrast drink may still be given to outline the bowel. It gives a clear picture of the organs, bones and other structures in this area and is used to investigate pain, injury, or suspected abnormalities.

Rates data updated July 2026.

Facilitymedian $62 · 10th–90th $62$620%50%100%$62Professionalmedian $112 · 10th–90th $78$3390%10%20%10th90th$112$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
26 · Professional part
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$223.87
Typical High
$338.84
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$77.62
Median
$81.28
Typical High
$229.09
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$67.61
Median
$194.98
Typical High
$3,801.89
Avera
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$331.13
Typical High
$501.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$446.68
Typical High
$562.34
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$151.36
Median
$190.55
Typical High
$239.88
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$204.17
Median
$251.19
Typical High
$316.23
Medica
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$302.00
Typical High
$575.44
Medica
Setting
Professional
Modifier
26 · Professional part
Typical Low
$95.50
Median
$162.18
Typical High
$245.47
Medica
Setting
Professional
Modifier
TC · Technical part
Typical Low
$114.82
Median
$169.82
Typical High
$323.59
Midlands
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$398.11
Typical High
$446.68
Midlands
Setting
Professional
Modifier
26 · Professional part
Typical Low
$165.96
Median
$173.78
Typical High
$204.17
Midlands
Setting
Professional
Modifier
TC · Technical part
Typical Low
$204.17
Median
$223.87
Typical High
$245.47
Midlands
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$407.38
Midlands
Setting
Professional
Modifier
26 · Professional part
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Midlands
Setting
Professional
Modifier
TC · Technical part
Typical Low
$229.09
Median
$229.09
Typical High
$229.09
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$323.59
Typical High
$363.08
Sanford Health Plan
Setting
Professional
Modifier
26 · Professional part
Typical Low
$102.33
Median
$144.54
Typical High
$158.49
Sanford Health Plan
Setting
Professional
Modifier
TC · Technical part
Typical Low
$131.83
Median
$181.97
Typical High
$204.17
United
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$363.08
Typical High
$501.19
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$95.50
Median
$144.54
Typical High
$186.21
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$114.82
Median
$204.17
Typical High
$281.84
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$407.38
Typical High
$407.38
Wellmark
Setting
Professional
Modifier
26 · Professional part
Typical Low
$154.88
Median
$177.83
Typical High
$177.83
Wellmark
Setting
Professional
Modifier
TC · Technical part
Typical Low
$199.53
Median
$229.09
Typical High
$229.09