CMS Price Transparency Data

CT scan, pelvis

Facility: Montrose Regional Health

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $452
Cash Discount Price: $854
vs. Medicare Baseline: 4.23x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Montrose Regional Health is $452. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $854. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.23x the Medicare baseline. Located in 800 S 3Rd St, Montrose, CO.

Cash / Self-Pay

$854

Average discount available for prompt cash payment at this facility.

Insurance Median

$452

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: $854 (800%)

Insurance Median: $452 (423%)

Cash: $854 (800% of Medicare)

Ins. Median: $452 (423% 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 423% of the Medicare baseline (a markup of 323%). 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
UnitedHealthcare	$44 - $1,608	41%
Blue Cross Blue Shield	$51 - $1,591	48%
Humana	$51 - $1,608	48%
Medicare (plans)	$51 - $118	48%
Montrose Community Healthplan-All Plans	$71 - $1,439	66%
United Rocky Mountain Chp-All Other Plans	$83 - $728	78%
United Rocky Mountain Private Plan	$84 - $1,566	79%
United Rocky Mountain Self Insured	$84 - $1,608	79%
Sloans Lake Managed Care-All Plans	$91 - $1,613	85%
United Rocky Mountain Mcaid	$102 - $1,139	95%
Three Rivers-All Plans	$159 - $1,608	149%
Western Healthcare Alliance-All Plans	$159 - $1,524	149%
Cigna	$168 - $1,608	157%
Multiplan-All Plans	$168 - $1,608	157%
Uchpa - All Plans	$168 - $1,608	157%

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 $854.
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 Montrose Regional Health 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.