CMS Price Transparency Data

CT scan, pelvis

Facility: Saint Mary's Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $372
  • Cash Discount Price: $1,057
  • vs. Medicare Baseline: 3.48x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Saint Mary's Hospital is $372. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,057. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.48x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$1,057

Average discount available for prompt cash payment at this facility.

Insurance Median
$372

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: $1,057 (990%)
Insurance Median: $372 (348%)
Cash: $1,057 (990% of Medicare)
Ins. Median: $372 (348% 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 348% of the Medicare baseline (a markup of 248%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Connecticut Dept of Correction $116 109%
Aetna $123 - $230 115%
Blue Cross Blue Shield $123 - $372 115%
Medicare (plans) $123 - $128 115%
UnitedHealthcare $123 - $1,921 115%
Cca Senior Care Options $125 117%
Cigna $127 - $1,537 119%
Geha $179 168%
Harvard Pilgrim Healthcare $179 168%
1199 National Benefit Fund $230 215%
Allied Benefit Systems $230 215%
Gravie Admin Services $230 215%
Hap $230 215%
Luminare Health $230 215%
Meritain $230 215%
Nippon Life Ins $230 215%
Webtpa $230 215%
Centivo $251 235%
Claimdoc $263 246%
Diversified Administrators $263 246%
Innovative Health Plan II $263 246%
Allegiance $338 316%
Health Partners $338 316%
Magnacare $338 316%
Bcn Domestic $372 348%
Blue Benefit Administrators of Massachusetts $372 348%
Blue Care Network $372 348%
Blue Distinction Transplant $372 348%
Blue Shield - Ca $372 348%
Blue Shield - Id (Regence) $372 348%
Blue Shield - Ny Highmark Northeastern $372 348%
Blue Shield - Ny Highmark Western $372 348%
Blue Shield - PA (Highmark) $372 348%
Blue Shield - Wa (Regence) $372 348%
Health Choices $372 348%
Kaiser Domestic $372 348%
Pre-Employment $372 348%
Unicare $372 348%
Wc Domestic $372 348%
Wellpoint $372 348%
Connecticare $469 - $478 439%
Carelon Behavioral Health $960 899%
Health New England $1,019 954%
Allied National Global Care $1,479 1385%
Asrm - Reliance Standard Life Insurance $1,479 1385%
Christian Care Ministry $1,479 1385%
Dean Health $1,479 1385%
Fallon Health $1,479 1385%
Family Life Insurance Company $1,479 1385%
Ghc Scw $1,479 1385%
International Benefit Administrators $1,479 1385%
Lifetime Benefit Solutions $1,479 1385%
Manhattan Life $1,479 1385%
Medi Share $1,479 1385%
Multiplan $1,479 1385%
Mvp $1,479 1385%
PHCS $1,479 1385%
Pai $1,479 1385%
Pan-American Life $1,479 1385%
Paramount HMO $1,479 1385%
Trinity Health Share $1,479 1385%
Prime Health Services $1,537 1439%
Health Smart $1,633 1529%
United Behavioral Health Eap $1,921 1799%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals