CMS Price Transparency Data

CT scan, pelvis

Facility: Sarasota Memorial Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $87
Cash Discount Price: $2,386
vs. Medicare Baseline: 0.81x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Sarasota Memorial Hospital is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,386. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.81x the Medicare baseline. Located in 1700 S Tamiami Trl, Sarasota, FL.

Cash / Self-Pay

$2,386

Average discount available for prompt cash payment at this facility.

Insurance Median

$87

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: $2,386 (2234%)

Insurance Median: $87 (81%)

Cash: $2,386 (2234% of Medicare)

Ins. Median: $87 (81% 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.

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
Simply Healthcare Oncology	$38 - $63	36%
Sunshine State Oncology	$38 - $63	36%
Molina Oncology	$39 - $65	37%
Amerihealth Caritas Oncology	$40 - $66	37%
Community Care Plan Oncology	$40 - $66	37%
Blue Cross Blue Shield	$48 - $132	45%
Florida Community Care Oncology	$48 - $100	45%
UnitedHealthcare	$53 - $4,479	50%
Wellcare Oncology	$54 - $85	51%
Simply Freedom Optimum Oncology	$56 - $89	52%
Aetna	$59 - $5,228	55%
Simply Healthcare	$67 - $71	63%
Sunshine State	$71	66%
Molina	$73	68%
Amerihealth Caritas	$74	69%
Community Care Plan	$74	69%
Florida Community Care	$74 - $117	69%
Oscar Oncology	$87 - $137	81%
Simply Freedom Optimum	$112	105%
Wellcare	$112	105%
Ambetter / Centene	$136 - $288	127%
Careworks	$2,671 - $5,228	2501%
Enlyte	$2,671 - $5,228	2501%
Avmed	$4,354	4076%
Usa Managed Care	$4,771	4467%
First Health	$4,950	4634%

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 $2,386.
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 Sarasota Memorial 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.