CT abdomen and pelvis with contrast at Fairbanks Memorial Hospital. CPT 74177.
What Fairbanks Memorial Hospital publishes for this service, straight from its standard-charges file, last updated June 16, 2026.
Outpatient / ER
$3,000cash price (self-pay)
$3,159list price
$387–$3,097range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Premera First - All Plans | Premera First - All Plans | $387 |
| Tricare (Hnfs) - All Plans | Tricare (Hnfs) - All Plans | $387 |
| Va (Triwest) - All Plans | Va (Triwest) - All Plans | $387 |
| Banner Choice - All Plans | Banner Choice - All Plans | $853 |
| Blue Cross Of Wa/Ak - All Plans | Blue Cross Of Wa/Ak - All Plans | $2,969 |
| UHC - All Plans | UHC - All Plans | $3,001 |
| Aetna/Ethix - All Plans | Aetna/Ethix - All Plans | $3,033 |
| Moda Health Plan - All Plans | Moda Health Plan - All Plans | $3,064 |
| Multiplan - All Plans | Multiplan - All Plans | $3,064 |
| First Choice (Cigna) - All Plans | First Choice (Cigna) - All Plans | $3,096 |
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