CMS Price Transparency Data

CT scan, pelvis

Facility: Mayers Memorial Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $996
Cash Discount Price: $902
vs. Medicare Baseline: 9.32x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Mayers Memorial Hospital is $996. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $902. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.32x the Medicare baseline. Located in 43563 Hwy 299 East, Fall River Mills, CA.

Cash / Self-Pay

$902

Average discount available for prompt cash payment at this facility.

Insurance Median

$996

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: $902 (844%)

Insurance Median: $996 (932%)

Cash: $902 (844% of Medicare)

Ins. Median: $996 (932% 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 932% of the Medicare baseline (a markup of 832%). 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
Blue Shield Ca Va	$48 - $946	45%
Blue Shield Mcr Adv	$48 - $946	45%
Tricare	$48 - $996	45%
Health Net Mcr Adv	$51 - $996	48%
Arcadian Health Services-All Plans	$53 - $996	50%
Imperial Health Plan-All Plans	$57 - $1,125	53%
Medi-Cal	$128 - $205	120%
Cigna	$280 - $1,433	262%
Corvel Ppo-All Plans	$280 - $1,433	262%
Coventry/First Health-All Plans	$280 - $1,433	262%
Integrated Hp-All Plans	$280 - $1,433	262%
Interplan-All Plans	$280 - $1,433	262%
Partnership Hp-All Plans	$819	767%
Blue Cross Blue Shield	$1,006 - $1,290	942%
Health Net Prison	$1,085	1016%
Blue Shield Ca Exchange	$1,290	1208%
Blue Shield-All Other Plans	$1,433	1342%
Hmn-All Plans	$1,433	1342%
Multiplan Phcs-All Plans	$1,433	1342%
Pfmc-All Plans	$1,433	1342%
Superior Ca-All Plans	$1,433	1342%
Health Net-All Other Plans	$1,501	1405%
Pacificare-All Plans	$1,509	1413%

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 $902.
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 Mayers Memorial 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.