CT abdomen and pelvis with contrast at Fairview Bethesda Hospital. CPT 74177.
What Fairview Bethesda Hospital publishes for this service, straight from its standard-charges file, last updated January 29, 2026.
Outpatient / ER
$607cash price (self-pay)
$1,832list price
$59.12–$1,649range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Itasca Medical Care | Managed Medicaid | $336 |
| Primewest | Managed Medicaid | $336 |
| South Country Health Alliance | PMAP | $336 |
| Primewest | MSHO | $355 |
| Sanford Health Plan | Medicare Advantage | $355 |
| Security Health Plan | Medicare Advantage | $355 |
| South Country Health Alliance | Medicare Advantage | $355 |
| United Healthcare | Medicare Advantage | $355 |
| WellCare | Medicare Advantage | $355 |
| Itasca Medical Care | Medicare Advantage/MSHO | $355 |
| UCare | Medicare Advantage/MSHO | $361 |
| Hennepin Health | PMAP | $363 |
| UCare | PMAP | $364 |
| Blue Cross of Minnesota | Medicare Advantage | $370 |
| Health Partners | Medicare Advantage | $377 |
| Medica | Medicare Advantage | $377 |
| Health Partners | Medicare Cost | $411 |
| Health Partners | PMAP | $418 |
| Blue Cross of Minnesota | Managed Medicaid | $458 |
| Medica | Minnesota Care/AccessAbility/Choice Care Government | $589 |
| UCare | Individual and Family with M Health Fairview | $625 |
| Medica | MSHO | $718 |
| UCare | Individual and Family | $817 |
| United Healthcare | Core | $965 |
| Health Partners | Federal | $981 |
| Health Partners | Commercial | $999 |
| United Healthcare | Commercial | $1,041 |
| Blue Cross of Minnesota | Aware Federal | $1,047 |
| Health Partners | Cigna Commercial | $1,049 |
| Blue Cross of Minnesota | Commercial | $1,065 |
Inpatient
$607cash price (self-pay)
$1,832list price
$405–$1,649range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross of Minnesota | Managed Medicaid | $490 |
| Health Partners | Medicare Cost | $605 |
| Health Partners | PMAP | $615 |
| Medica | Minnesota Care/AccessAbility/Choice Care Government | $652 |
| Medica | MSHO | $736 |
| UCare | PMAP | $767 |
| America's PPO | EZCare | $954 |
| United Healthcare | Core | $970 |
| Blue Cross of Minnesota | Aware Federal | $1,030 |
| United Healthcare | Commercial | $1,046 |
| Blue Cross of Minnesota | Commercial | $1,048 |
| Sanford Health Plan | Commercial | $1,079 |
| America's PPO | Health EZ | $1,081 |
| Medica | BOLD | $1,114 |
| Medica | City of St Paul and Essential/Uplan | $1,114 |
| Medica | Vantage SI | $1,114 |
| Health Partners | Federal | $1,121 |
| Health Partners | Commercial | $1,141 |
| America's PPO | Commercial | $1,171 |
| Health Partners | Cigna Commercial | $1,198 |
| Medica | Choice | $1,238 |
| Medica | Individual and Family, Elect | $1,238 |
| Security Health Plan | Commercial | $1,374 |
| Health Partners | Cigna Great West | $1,427 |
| First Health | Commercial | $1,502 |
| MultiPlan | Commercial | $1,557 |
| Private Healthcare Systems | Commercial | $1,557 |
| Wisconsin Physician Services | Commercial | $1,649 |
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