Sanford Clear Lake Medical Center — CT scan prices
← Hospital overviewVerified from Sanford Clear Lake Medical Center’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
14 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| CT ABD PELVIS W CONTRAST Outpatient | 74177 CPT | $5,879 | $4,703 | $1,216 – $5,467 | — | |
| CT ABD PELVIS W CONTRAST Inpatient | 74177 CPT | $5,879 | $4,703 | $3,233 – $5,467 | — | |
| CT ABD PELVIS WO CONTRAST Outpatient | 74176 CPT | $5,084 | $4,067 | $1,156 – $4,728 | — | |
| CT ABD PELVIS WO CONTRAST Inpatient | 74176 CPT | $5,084 | $4,067 | $2,796 – $4,728 | — | |
| CT ABD PELVIS WO THEN W CONT Outpatient | 74178 CPT | $6,638 | $5,310 | $1,216 – $6,173 | — | |
| CT ABD PELVIS WO THEN W CONT Inpatient | 74178 CPT | $6,638 | $5,310 | $3,651 – $6,173 | — | |
| CT HEAD W CONTRAST Outpatient | 70460 CPT | $3,072 | $2,458 | $893 – $2,857 | — | |
| CT HEAD W CONTRAST Inpatient | 70460 CPT | $3,072 | $2,458 | $1,690 – $2,857 | — | |
| CT HEAD WO CONTRAST Outpatient | 70450 CPT | $2,599 | $2,079 | $941 – $2,417 | — | |
| CT HEAD WO CONTRAST Inpatient | 70450 CPT | $2,599 | $2,079 | $1,429 – $2,417 | — | |
| CT THORAX DIAGNOSTIC WITH CONTRAST Outpatient | 71260 CPT | $3,333 | $2,666 | $893 – $3,099 | — | |
| CT THORAX DIAGNOSTIC WITH CONTRAST Inpatient | 71260 CPT | $3,333 | $2,666 | $1,833 – $3,099 | — | |
| CT THORAX DIAGNOSTIC WO CONTRAST Outpatient | 71250 CPT | $2,736 | $2,189 | $705 – $2,544 | — | |
| CT THORAX DIAGNOSTIC WO CONTRAST Inpatient | 71250 CPT | $2,736 | $2,189 | $1,505 – $2,544 | — |