CMS Price Transparency Data

CT scan, pelvis

Facility: Los Robles Hospital & Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $2,231
Cash Discount Price: $6,667
vs. Medicare Baseline: 20.89x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Los Robles Hospital & Medical Center is $2,231. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,667. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.89x the Medicare baseline. Located in 215 W Janss Rd, Thousand Oaks, CA.

Cash / Self-Pay

$6,667

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,231

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: $6,667 (6242%)

Insurance Median: $2,231 (2089%)

Cash: $6,667 (6242% of Medicare)

Ins. Median: $2,231 (2089% 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 2089% of the Medicare baseline (a markup of 1989%). 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
Brand New Day	$129	121%
Gold Coast Health Plan	$129	121%
United	$245 - $2,023	229%
Blue Cross Blue Shield	$249 - $721	233%
Medcare Partners	$372 - $1,080	348%
Aetna	$1,263 - $7,200	1182%
First Health	$1,686 - $5,760	1579%
Choicecare Network	$1,735 - $5,040	1624%
Multiplan	$1,983 - $6,840	1857%
Ppo Next	$1,983 - $5,760	1857%
Interplan Corporation	$2,231 - $6,480	2089%
Ventura County Foundation	$2,231 - $6,480	2089%
Blue Shield	$2,918 - $4,169	2732%

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 $6,667.
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 Los Robles Hospital & Medical Center 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.