CMS Price Transparency Data

CT scan, pelvis

Facility: Medical Center Enterprise

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $113
  • Cash Discount Price: $1,445
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Medical Center Enterprise is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,445. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.06x the Medicare baseline. Located in 400 N Edwards Street, Enterprise, AL.
Cash / Self-Pay
$1,445

Average discount available for prompt cash payment at this facility.

Insurance Median
$113

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: $1,445 (1353%)
Insurance Median: $113 (106%)
Cash: $1,445 (1353% of Medicare)
Ins. Median: $113 (106% 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.

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
Al Maternity Waiver Program $47 44%
Medicaid / KanCare $62 - $67 58%
Tricare $86 81%
Blue Cross Blue Shield $89 - $154 83%
Humana $89 83%
Medicare (plans) $89 83%
UnitedHealthcare $89 - $224 83%
Covenant Hospice $90 84%
Dayspring Hospice $90 84%
Healthspring $90 84%
Node Champva $90 84%
Node Devoted Health Mcr Adv $90 84%
Node Hospice Non Par $90 84%
Node Va $90 84%
Select Health $90 84%
Southerncare Hospice $90 84%
Aetna $91 - $5,188 85%
Node Clover Mcr Adv $91 85%
Node Wellcare Mcr Adv $92 86%
Veterans Eval Services $92 86%
Eon Health $93 87%
Wiregrass Hospice $96 90%
Node Us Dept Of Labor $113 106%
Ambetter / Centene $135 126%
Cigna $152 - $957 142%
Occunet $375 351%
Self Pay $667 - $2,223 624%
American Employee Alliance $2,964 2775%
Alamed $4,446 4163%
Affordable Health $5,188 4857%
Health Choice $5,188 4857%
Novanet Ppo $5,188 4857%
Coventry Work Comp Al $5,454 5106%
Multiplan $5,484 - $5,854 5134%
Wc Dept Ind Relations $5,929 5551%
Corvel $6,299 5897%
Galaxy Health $6,670 6245%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N Edwards Street, Enterprise, AL 36330
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals