CMS Price Transparency Data

CT scan, pelvis

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $107
Cash Discount Price: $404
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Cleveland Clinic Indian River Hospital is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $404. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.00x the Medicare baseline. Located in 1000 36Th St, Vero Beach, FL.

Cash / Self-Pay

$404

Average discount available for prompt cash payment at this facility.

Insurance Median

$107

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: $404 (378%)

Insurance Median: $107 (100%)

Cash: $404 (378% of Medicare)

Ins. Median: $107 (100% 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
Blue Cross Blue Shield	$48 - $1,506	45%
Avmed	$51 - $244	48%
Careplus	$51 - $107	48%
Magellan	$51 - $509	48%
United	$51 - $107	48%
Value Options	$51	48%
Wellcare	$51 - $107	48%
Freedom Health	$53 - $107	50%
Independent Living Systems	$53 - $112	50%
Wellmed	$53 - $107	50%
Clear Spring Health	$55 - $188	51%
Aetna	$61 - $1,216	57%
Cigna	$61 - $255	57%
Carelon Bh Strategies	$107	100%
Humana	$107	100%
Devoted Health	$117	110%
Clarity Health	$255 - $552	239%
The Legacy Companies	$255 - $552	239%
National Provider Network	$275	257%
Three Rivers	$275	257%
Consociate Health	$295	276%
Bmi	$467	437%
Multiplan	$679	636%

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 $404.
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 Cleveland Clinic Indian River 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.