CMS Price Transparency Data

CT scan, pelvis

Facility: Central Florida Lake Monroe Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $5,952
  • Cash Discount Price: $19,201
  • vs. Medicare Baseline: 55.73x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Central Florida Lake Monroe Hospital is $5,952. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,201. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 55.73x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.
Cash / Self-Pay
$19,201

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,952

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: $19,201 (17977%)
Insurance Median: $5,952 (5573%)
Cash: $19,201 (17977% of Medicare)
Ins. Median: $5,952 (5573% 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 5573% of the Medicare baseline (a markup of 5473%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
United $245 - $8,641 229%
Aetna $1,186 - $5,760 1110%
Freedom Health $1,382 1294%
Optimum $1,382 1294%
Avmed $1,695 - $9,601 1587%
Corvel Corporation $2,416 2262%
Prime Health $2,467 2310%
Careworks (Rockport Community) $2,543 2381%
Simply $2,957 2768%
Molina Healthcare $3,648 - $6,144 3415%
Sunshine State Health Plan $4,896 4584%
Plotkin Health $9,601 8989%
Prime Health Sheriff $9,601 8989%
Multiplan $14,401 - $16,321 13483%
Three Rivers Provider Network $14,401 13483%
Ppo Next $16,321 15280%
Novanet $17,281 16179%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 W Seminole Blvd, Sanford, FL 32771
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals