CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Fairbanks Memorial Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $3,002
Cash Discount Price: $3,001
vs. Medicare Baseline: 8.42x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Fairbanks Memorial Hospital is $3,002. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,001. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 8.42x the Medicare baseline. Located in 1650 Cowles Street, Fairbanks, AK.

Cash / Self-Pay

$3,001

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,002

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)

Cash / Self-Pay: $3,001 (842%)

Insurance Median: $3,002 (842%)

Cash: $3,001 (842% of Medicare)

Ins. Median: $3,002 (842% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 842% of the Medicare baseline (a markup of 742%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Premera First - All Plans	$387	109%
Tricare	$387	109%
Va (Triwest) - All Plans	$387	109%
Banner Choice - All Plans	$853	239%
Blue Cross Blue Shield	$2,968 - $2,971	833%
UnitedHealthcare	$3,000 - $3,002	842%
Aetna	$3,031 - $3,034	850%
Moda Health Plan - All Plans	$3,063 - $3,066	859%
Multiplan - All Plans	$3,063 - $3,066	859%
Cigna	$3,094 - $3,097	868%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $3,001.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 74177.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Fairbanks Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 74177.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.