CMS Price Transparency Data

CT scan, pelvis

Facility: The East Alabama Healthcare Authority

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $188
Cash Discount Price: $270
vs. Medicare Baseline: 1.76x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at The East Alabama Healthcare Authority is $188. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $270. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.76x the Medicare baseline. Located in 2000 Pepperell Parkway, Opelika, AL.

Cash / Self-Pay

$270

Average discount available for prompt cash payment at this facility.

Insurance Median

$188

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $270 (253%)

Insurance Median: $188 (176%)

Cash: $270 (253% of Medicare)

Ins. Median: $188 (176% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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.

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
Aetna	$47 - $490	44%
Blue Cross Blue Shield	$47 - $188	44%
Cigna	$47 - $190	44%
Humana	$47 - $343	44%
Simpra	$47 - $96	44%
Viva	$47 - $239	44%
Novanet	$74	69%
Beechstreet	$92 - $416	86%
Alabama Crime Victims	$245	229%
Mcm Maxcare	$392	367%
Mega Life	$392	367%
UnitedHealthcare	$392	367%
Coventry First Health	$416	389%
Geha	$416	389%
Multiplan	$416	389%
Workers Comp	$416	389%
Trpn	$441	413%

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 $270.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72192.

Insurance In-Network Protection Plan

Contact your insurance company to confirm The East Alabama Healthcare Authority is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72192.
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.