CMS Price Transparency Data

CT scan, pelvis

Facility: HCA Healthone Presbyterian St Luke's

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,382
Cash Discount Price: $4,686
vs. Medicare Baseline: 12.94x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at HCA Healthone Presbyterian St Luke's is $1,382. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,686. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.94x the Medicare baseline. Located in 1719 E 19Th Ave, Denver, CO.

Cash / Self-Pay

$4,686

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,382

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: $4,686 (4387%)

Insurance Median: $1,382 (1294%)

Cash: $4,686 (4387% of Medicare)

Ins. Median: $1,382 (1294% 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 1294% of the Medicare baseline (a markup of 1194%). 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 Cross Blue Shield	$123 - $3,468	115%
Pinnacol Workers Comp	$169	158%
Multiplan	$176 - $4,218	165%
United	$185 - $2,109	173%
Rocky Mountain Health Plan	$245	229%
Vail Health	$712	667%
Aetna	$1,164 - $1,763	1090%
Cigna	$1,359 - $2,999	1272%
Bright Health	$1,406	1316%
Emerging Therapy Solutions	$2,249 - $2,999	2106%
Kaiser National Transplant	$2,249	2106%
Colorado Program For Children With Special Needs	$2,390	2238%
Western Plains Community Health	$3,046	2852%
Northcare	$3,280	3071%
Physician Health Partners	$3,280	3071%
Medical Development International	$3,749	3510%
Prime Health	$4,218	3949%

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 $4,686.
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 HCA Healthone Presbyterian St Luke's 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.