CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Sanford Behavioral Health Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $2,952
Cash Discount Price: $3,747
vs. Medicare Baseline: 8.28x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Sanford Behavioral Health Center is $2,952. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,747. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 8.28x the Medicare baseline. Located in 120 Labree Avenue South, Thief River Falls, MN.

Cash / Self-Pay

$3,747

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,952

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)

Cash / Self-Pay: $3,747 (1051%)

Insurance Median: $2,952 (828%)

Cash: $3,747 (1051% of Medicare)

Ins. Median: $2,952 (828% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 828% of the Medicare baseline (a markup of 728%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Primewest	$375 - $1,967	105%
Ucare	$375 - $4,115	105%
Blue Cross Blue Shield	$608 - $1,930	171%
Sanford Health Plan Align	$1,780	499%
Aetna	$1,930 - $4,070	541%
Health Partners	$1,930 - $3,794	541%
Medicare (plans)	$1,930	541%
UnitedHealthcare	$1,930 - $3,911	541%
Sanford Health Plan	$2,510 - $2,952	704%
Security Health Plan	$2,576	723%
Medica	$4,117 - $4,431	1155%
Cigna	$4,216	1183%
First Choice Health Network	$4,216	1183%
Healthez	$4,216	1183%
Multiplan	$4,216	1183%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $3,747.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 74177.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sanford Behavioral Health Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 74177.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.