CMS Price Transparency Data

CT scan, pelvis

Facility: Hialeah Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $113
  • Cash Discount Price: $7,633
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Hialeah Hospital is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,633. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.06x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$7,633

Average discount available for prompt cash payment at this facility.

Insurance Median
$113

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: $7,633 (7146%)
Insurance Median: $113 (106%)
Cash: $7,633 (7146% of Medicare)
Ins. Median: $113 (106% 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.

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
Humana $68 - $206 64%
Medicaid / KanCare $68 - $72 64%
UnitedHealthcare $69 - $103 65%
Veterans Administration Mill Bill $72 67%
Medicare (plans) $93 - $225 87%
Aetna $103 - $5,496 96%
Devoted Health $103 96%
Leon Health Inc $103 96%
Avmed Broad Network $104 97%
Tricare $104 97%
Bristol Hospice- Miami Dade Llc $105 98%
Catholic Hospice $105 98%
Comprehensive Home Health Care Dba Opuscare Of South Florida $105 98%
Employer Direct Healthcare $105 - $171 98%
Hcr Manor Care Services Of Fl $105 98%
Hospice Other $105 98%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $105 98%
Seasons Hospice And Pallative Care Of Southern Florida Inc $105 98%
Veterans Administration Vaccn $105 98%
Vitas Healthcare Hospice Corporation Of Fl $105 98%
Vitas Hospice Unit Agreement $105 98%
Cigna $108 - $2,244 101%
Healthsun Health Plans $108 - $141 101%
Longevity Health Plan $109 102%
Dimension Health Wc $113 106%
Workers Compensation $113 106%
Florida Pace Centers $124 116%
Bright Health Management Commercial $126 118%
Self Pay/Uninsured $129 - $168 121%
Imagine Health $144 135%
Naphcare Inc $144 135%
Avmed Exchange $183 171%
Ambetter / Centene $194 182%
Oscar Health Plan Hix $196 184%
Molina Marketplace Program Exchange $199 186%
Auto Insurance $209 196%
Avmed Select Network $214 200%
Amerihealth Caritas Next Exchange $225 211%
Bc/Bs Of Fl Miami Dade Blue Select $258 242%
Bc/Bs Of Fl Health Options Hmo $330 309%
Bc/Bs Of Fl Network Blue $333 312%
Bc/Bs Myblue Hmo Hix $339 317%
Bc/Bs Of Fl Simplyblue $356 333%
Bc/Bs Of Fl Blue Select Exchange Non Par $367 344%
Bc/Bs Of Fl Ppo $387 362%
Bc/Bs Of Fl Phs $3,957 3705%
Dimensions International $4,962 4646%
First Health $5,191 4860%
Dimension Health Ppo $5,725 5360%
Commercial Non-Contracted $7,633 7146%
Self Pay - Mcd Pending 100 Percent $7,633 7146%
Single Case Agreement $7,633 7146%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 E 25Th St, Hialeah, FL 33013
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals