CMS Price Transparency Data

CT scan, pelvis

Facility: Grossmont Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,628
Cash Discount Price: $1,961
vs. Medicare Baseline: 15.24x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Grossmont Hospital is $1,628. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,961. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.24x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$1,961

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,628

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: $1,961 (1836%)

Insurance Median: $1,628 (1524%)

Cash: $1,961 (1836% of Medicare)

Ins. Median: $1,628 (1524% 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 1524% of the Medicare baseline (a markup of 1424%). 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
Health Net	$392 - $2,563	367%
UnitedHealthcare	$392 - $1,634	367%
Aetna	$777 - $1,961	727%
Multiplan	$798	747%
County Medical Services	$880 - $1,830	824%
Blue Cross Blue Shield	$889 - $2,354	832%
Blue Shield	$889 - $1,668	832%
Molina	$889 - $2,092	832%
Humana	$1,321 - $1,830	1237%
Community Health Group	$1,477	1383%
California Health And Wellness	$1,668 - $1,735	1562%
Kaiser	$1,715	1606%
Medicare (plans)	$1,804	1689%
Cigna	$1,830	1713%
Indian Health Council	$1,830	1713%
Allianz Global Assistance	$2,354	2204%

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 $1,961.
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 Grossmont Hospital 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.