CMS Price Transparency Data

CT scan, pelvis

Facility: HCA Florida Jfk Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $2,587
Cash Discount Price: $16,169
vs. Medicare Baseline: 24.22x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at HCA Florida Jfk Hospital is $2,587. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,169. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 24.22x the Medicare baseline. Located in 5301 S Congress Ave, Atlantis, FL.

Cash / Self-Pay

$16,169

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,587

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: $16,169 (15138%)

Insurance Median: $2,587 (2422%)

Cash: $16,169 (15138% of Medicare)

Ins. Median: $2,587 (2422% 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 2422% of the Medicare baseline (a markup of 2322%). 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 - $7,276	229%
Healthy Palm Beaches	$550	515%
Aetna	$868 - $4,851	813%
Avmed	$890 - $8,084	833%
Freedom Health	$1,391 - $2,587	1302%
Optimum	$1,391	1302%
Simply Healthcare Plans	$2,102	1968%
Corvel Corporation	$2,532	2371%
Careworks (Rockport)	$2,586	2421%
Prime Health	$2,586	2421%
Molina	$2,749 - $4,366	2574%
Health Sun Health Plan	$3,444	3224%
Aids Healthcare	$3,557 - $19,403	3330%
Mmm Of Fl (Health Advantage Plan)	$3,719	3482%
United Ppo	$3,832	3588%
Sunshine State Health Plan	$4,204	3936%
Blis	$5,659	5298%
District Cares	$8,084	7569%
Plotkin Health	$8,084	7569%
Prime Health Sherriff	$8,084	7569%
Medica Healthcare	$9,540	8932%
Multiplan	$12,127 - $13,744	11354%
Evernorth Bh	$12,935	12110%

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 $16,169.
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 Jfk 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.