CMS Price Transparency Data

CT scan, pelvis

Facility: Gunnison Valley Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $302
Cash Discount Price: $920
vs. Medicare Baseline: 2.83x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Gunnison Valley Hospital is $302. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $920. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.83x the Medicare baseline. Located in 711 N Taylor St, Gunnison, CO.

Cash / Self-Pay

$920

Average discount available for prompt cash payment at this facility.

Insurance Median

$302

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: $920 (861%)

Insurance Median: $302 (283%)

Cash: $920 (861% of Medicare)

Ins. Median: $302 (283% 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 283% of the Medicare baseline (a markup of 183%). 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
Cigna	$45 - $1,813	42%
Medicare (plans)	$50 - $906	47%
Aetna	$73 - $1,776	68%
Apostrophe-All Plans	$83 - $1,665	78%
Medicaid / KanCare	$145 - $148	136%
Gunnison County Sheriff Op & Profee Only	$162 - $950	152%
Ebms Hdhp	$189 - $1,110	177%
Tetwp Op & Profee Only-All Plans	$189 - $1,110	177%
U Of Co Transplant-All Plans	$189 - $1,110	177%
Ebms Ppo Plan-All Other Plans	$220 - $1,295	206%
Gunnison County Employees-All Other Plans	$252 - $1,480	236%
Scottish Rites-All Plans	$252 - $1,480	236%
Elap Employers-All Plans	$268 - $1,572	251%
Blue Cross Blue Shield	$276 - $1,622	258%
Multiplan-All Plans	$284 - $1,720	266%
Rocky Mountain Health-All Plans	$299 - $1,758	280%
UnitedHealthcare	$299 - $1,758	280%
Cofinity-All Plans	$302 - $1,776	283%
Gunnison County Coroner Op Only	$950	889%

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 $920.
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 Gunnison Valley 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.