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South Dakota rates for HCPCS 74177

Computed tomography, abdomen and pelvis; with contrast material(s)

Facilitymedian $87 · 10th–90th $65$870%50%10th$87Professionalmedian $166 · 10th–90th $81$6760%20%10th90th$166$20.0$100.0$500.0$2.0K$10.0K

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
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$64.57 / $87.10 / $87.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $562.34 / $3,467.37
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$79.43 / $89.13 / $239.88
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$218.78 / $416.87 / $4,168.69
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $512.86 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $741.31 / $912.01
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$162.18 / $199.53 / $251.19
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$426.58 / $537.03 / $676.08
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $436.52 / $891.25
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$109.65 / $177.83 / $426.58
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$223.87 / $331.13 / $630.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $660.69 / $707.95
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$173.78 / $181.97 / $213.80
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$436.52 / $467.74 / $501.19
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Midlands
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Midlands
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $512.86 / $588.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$104.71 / $151.36 / $165.96
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$269.15 / $363.08 / $426.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $562.34 / $776.25
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$91.20 / $151.36 / $229.09
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$245.47 / $407.38 / $549.54
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $691.83 / $691.83
Wellmark
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$165.96 / $194.98 / $194.98
Wellmark
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$426.58 / $501.19 / $501.19