CMS Price Transparency Data

CT scan, pelvis

Facility: HCA Florida Twin Cities Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $4,151
Cash Discount Price: $13,837
vs. Medicare Baseline: 38.86x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at HCA Florida Twin Cities Hospital is $4,151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,837. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 38.86x the Medicare baseline. Located in 2190 Hwy 85 N, Niceville, FL.

Cash / Self-Pay

$13,837

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,151

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: $13,837 (12955%)

Insurance Median: $4,151 (3886%)

Cash: $13,837 (12955% of Medicare)

Ins. Median: $4,151 (3886% 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 3886% of the Medicare baseline (a markup of 3786%). 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
United	$245 - $6,227	229%
Avmed	$1,695 - $6,918	1587%
Aetna	$1,696 - $4,151	1588%
Simply	$2,131	1995%
Corvel Corporation	$2,438	2283%
Prime Health	$2,490	2331%
Careworks (Rockport Community)	$2,567	2403%
Molina Healthcare	$2,629 - $4,428	2461%
Sunshine State Health Plan	$3,528	3303%
Plotkin Health	$6,918	6477%
Prime Health Sheriff	$6,918	6477%
Evolutions Healthcare	$8,994 - $11,761	8421%
Multiplan	$10,793 - $11,761	10105%
Ppo Next	$11,761	11011%
Novanet	$12,453	11659%

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 $13,837.
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 Florida Twin Cities 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.