CMS Price Transparency Data

CT scan, pelvis

Facility: Nemours Children's Hospital, Delaware

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,811
  • Cash Discount Price: $3,177
  • vs. Medicare Baseline: 16.96x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Nemours Children's Hospital, Delaware is $1,811. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,177. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.96x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$3,177

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,811

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: $3,177 (2974%)
Insurance Median: $1,811 (1696%)
Cash: $3,177 (2974% of Medicare)
Ins. Median: $1,811 (1696% 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 1696% of the Medicare baseline (a markup of 1596%). 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
Us Family Health Plan $52 49%
Tricare $111 104%
Celtic Transplant $229 - $3,177 214%
Keystone First Hlth Plan $634 - $1,406 594%
Amerihealth Caritas Delaware $973 - $1,811 911%
Celtic Transplant For De First Health $1,112 1041%
UnitedHealthcare $1,166 - $1,982 1092%
Wellpoint Maryland $1,175 1100%
Kidz Partners $1,202 1125%
Health Partners $1,232 1153%
Upmc $1,258 1178%
Fidelis $1,271 1190%
Aetna $1,348 - $1,843 1262%
Blue Cross Blue Shield $1,394 - $2,806 1305%
Priority Partners John Hopkins $1,558 1459%
Six Degrees Health Transplant $1,588 1487%
Cigna $1,747 - $2,002 1636%
Great West-One Health Plan $1,747 - $2,002 1636%
Ambetter / Centene $1,811 1696%
Geisinger Health Plan $1,906 1784%
Integra Administrative Group $1,906 1784%
National Transplant Network (Ntn) $2,065 1933%
Six Degrees Health $2,065 1933%
Star Healthcare Network $2,065 1933%
Life Trac Solid Organ And Bmt Transplant $2,224 2082%
First Health Network $3,018 2826%
Insurance Administrators Of America $3,018 2826%
Interlink Transplant Network $3,018 2826%
Multiplan $3,018 2826%
Preferred Healthcare $3,018 2826%
Private Healthcare Systems $3,018 2826%
Three Rivers Provider Network $3,018 2826%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens