CMS Price Transparency Data

CT scan, pelvis

Facility: Chinese Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $267
Cash Discount Price: $2,734
vs. Medicare Baseline: 2.50x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Chinese Hospital is $267. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,734. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.50x the Medicare baseline. Located in 845 Jackson St, San Francisco, CA.

Cash / Self-Pay

$2,734

Average discount available for prompt cash payment at this facility.

Insurance Median

$267

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: $2,734 (2560%)

Insurance Median: $267 (250%)

Cash: $2,734 (2560% of Medicare)

Ins. Median: $267 (250% 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 250% of the Medicare baseline (a markup of 150%). 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
Aetna	$151 - $1,323	141%
Cchp Mcr Adv	$151	141%
Jade Mcr Adv	$151	141%
Blue Cross Blue Shield	$153 - $212	143%
Jade-All Other Plans	$166	155%
On Lok Mcr Adv-All Plans	$166	155%
Medi-Cal	$205	192%
San Francisco Health Plan- All Plans	$205	192%
Hp Of San Mateo Medi-Cal	$252	236%
Blue Shield - All Other Plans	$261	244%
Hp Of San Mateo Health Kids/Health Worx-All Other	$272	255%
Blue Shield Medi-Cal	$276	258%
Asian Medical Group Medi-Cal Op Only	$286	268%
Jade Medi-Cal	$368	345%
Health Net-All Plans	$1,449	1357%
Cigna	$1,504	1408%
Cchp-All Other Plans	$2,324	2176%
Hp Of San Mateo Mcr Adv	$2,461	2304%
Asian Medical Group Mcare Op Only-All Other Plans	$2,734	2560%
Bay Area Accountable Care Mcare	$2,734	2560%
Bay Area Accountable Care - All Other Plans	$4,921	4607%

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 $2,734.
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 Chinese 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.