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CT abdomen and pelvis with contrast

CPT 74177 · negotiated-rate distribution across hospitals in SD

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Hospitals
5
Min
$3,665.57
Median
$5,306.87
Max
$5,968.00
Range multiplier
1.6×

By payer (36 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
TRICARE472$376.09$2,019.89$3,772.4010.0×
UnitedHealthcare536$1,531.88$5,361.58$5,968.003.9×
Blue Cross Blue Shield527$966.00$4,869.19$5,968.006.2×
Cigna424$5,252.16$5,416.29$5,416.291.0×
medica (commercial) 94265 [3081118]424$4,540.93$5,361.58$5,361.581.2×
govt employees health assn [3081090]424$3,610.86$5,361.58$5,361.581.5×
healthpartners [3081368]421$393.00$5,361.58$5,361.5813.6×
national telephone cooperative assn 52103 [3081149]416$3,610.86$5,361.58$5,361.581.5×
Meritain Health416$5,252.16$5,416.29$5,416.291.0×
risk admin svs [3081167]416$609.25$2,493.03$4,376.807.2×
Aetna412$4,923.90$5,060.68$5,197.451.1×
Humana510$318.78$5,471.00$5,968.0018.7×
tlc advantage llc [3081189]59$5,142.74$5,142.74$5,348.601.0×
avera health plans 46045 [3081018]59$4,021.19$5,306.87$5,306.871.3×
midlands choice 47080 [3081136]48$5,252.16$5,416.29$5,416.291.0×
allied benefit systems inc [3081320]48$5,252.16$5,416.29$5,416.291.0×
coresource 38225 [3081146]48$3,556.15$4,923.90$4,923.901.4×
employee benefit management 12x44 [3081079]48$4,650.35$4,923.90$4,923.901.1×
fedmed inc [3081283]48$5,197.45$5,306.87$5,306.871.0×
health partners sx009 [3081102]48$3,392.02$5,361.58$5,361.581.6×
key benefit administrators [3081332]48$5,252.16$5,416.29$5,416.291.0×
pacificsource health plans [3081333]48$4,650.35$4,923.90$4,923.901.1×
preferred one 41147 [3081160]48$5,252.16$5,416.29$5,416.291.0×
rocky mountain admin llc 83028 [3081168]48$4,376.80$4,923.90$4,923.901.1×
sanford health plan 91184 [3081174]48$4,923.90$5,306.87$5,306.871.1×
surest [3081369]48$3,610.86$5,361.58$5,361.581.5×
va ccn optum [3081339]44$303.60$1,531.88$2,024.276.7×
Medicare44$1,531.88$1,778.08$5,968.003.9×
Multiplan24$4,923.90$5,115.39$5,306.871.1×
group and pension administrators inc [3081098]24$4,923.90$5,115.39$5,306.871.1×
va black hills health care system 12115 [3081206]44$303.60$1,531.88$2,024.276.7×
va black hills health care system 12115 [3081207]33$1,531.88$1,531.88$2,024.271.3×
VA Health33$1,531.88$1,531.88$2,024.271.3×
Health Net33$1,531.88$1,531.88$2,024.271.3×
triwest healthcare alliance [3081322]33$1,531.88$1,531.88$2,024.271.3×
minnesota health care programs 12k16 [3081295]12$1,657.71$1,657.71$1,657.711.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Monument Health Spearfish HospitalSpearfishSD6$5,690.00$5,690.00$966.00$5,968.00$5,968.00
Monument Health Custer HospitalCusterSD35$5,471.00$5,471.00$609.25$5,361.58$5,471.00
Monument Health Lead-Deadwood HospitDeadwoodSD33$5,471.00$5,471.00$609.25$5,306.87$5,471.00
Monument Health Sturgis RegionalSturgisSD33$5,471.00$5,471.00$609.25$5,306.87$5,471.00
Monument Health Rapid City HospitalRapid CitySD31$5,471.00$5,471.00$303.60$3,665.57$5,252.16

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.