CMS Price Transparency Data

CT scan, pelvis

Facility: Grandview Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $4,262
  • Cash Discount Price: $1,972
  • vs. Medicare Baseline: 39.90x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Grandview Medical Center is $4,262. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,972. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 39.90x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$1,972

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,262

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: $1,972 (1846%)
Insurance Median: $4,262 (3990%)
Cash: $1,972 (1846% of Medicare)
Ins. Median: $4,262 (3990% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 3990% of the Medicare baseline (a markup of 3890%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Medicaid / KanCare $62 58%
Encompass Health $80 75%
Tricare $91 85%
Veterans Eval Services $92 86%
Blue Advantage $94 88%
Humana $94 88%
Medicare (plans) $94 88%
UnitedHealthcare $94 - $4,795 88%
Victory Health $94 88%
Viva Health $94 - $5,860 88%
Select Health $95 89%
Cigna $96 - $170 90%
Hospice $96 90%
Node Champva $96 90%
Node Devoted Health Mcr Adv $96 90%
Node Va $96 90%
Aetna $97 - $2,962 91%
Node Clover Health Mcr Adv $97 91%
Node Wellcare Mcr Adv $98 92%
Node Us Dept Of Labor $120 112%
Ambetter / Centene $143 134%
Healthspring $167 156%
Blue Cross Blue Shield $201 188%
Choicecare $650 609%
Alamed $1,248 1168%
Self Pay $1,467 - $2,557 1373%
Bp Health Advocate $2,444 - $2,664 2288%
Ag Administrators $3,422 - $3,729 3204%
Drummond $3,422 - $3,729 3204%
First Health $3,500 - $8,332 3277%
American Employee Alliance $3,911 - $4,262 3662%
Healthchoice $4,889 - $6,393 4577%
Value Options $4,889 - $5,328 4577%
Multiplan $5,965 - $7,458 5585%
Blue Bell Creameries $6,845 - $7,458 6409%
Natl Comp Care $7,334 - $7,991 6866%
Usa Ppo $7,334 - $7,991 6866%
Coventry Work Comp Al $7,646 - $8,332 7159%
Novanet $7,896 - $8,604 7393%
Alabama Wc $8,311 - $9,057 7781%
Cal-Med $8,311 - $9,057 7781%
Corvel $8,311 - $9,057 7781%
Associated Admin $8,800 - $9,590 8239%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals