Sanford Jackson Hospital — CT scan prices
← Hospital overviewVerified from Sanford Jackson Hospital’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.
7 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| CT abd pelvis w contrast Inpatient | 74177 CPT | $5,787 | $4,630 | $3,101 – $5,475 | — | |
| CT abd pelvis without contrast Inpatient | 74176 CPT | $4,606 | $3,685 | $2,468 – $4,357 | — | |
| CT abd pelvis without then w cont Inpatient | 74178 CPT | $6,481 | $5,185 | $3,473 – $6,131 | — | |
| CT head w contrast Inpatient | 70460 CPT | $3,209 | $2,567 | $1,719 – $3,036 | — | |
| CT head without contrast Inpatient | 70450 CPT | $2,717 | $2,174 | $1,456 – $2,570 | — | |
| CT thorax diagnostic with contrast Inpatient | 71260 CPT | $3,658 | $2,926 | $1,960 – $3,460 | — | |
| CT thorax diagnostic without contrast Inpatient | 71250 CPT | $2,792 | $2,234 | $1,496 – $2,641 | — |