CMS Price Transparency Data
CT scan, pelvis
Facility: Palmetto General Hospital
Billing Code: 72192 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72192
- Insurance Median: $124
- Cash Discount Price: $7,633
- vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Palmetto General Hospital is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,633. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.16x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$7,633
Average discount available for prompt cash payment at this facility.
Insurance Median
$124
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: $7,633 (7146%)
Insurance Median: $124 (116%)
Cash: $7,633 (7146% of Medicare)
Ins. Median: $124 (116% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Humana | $68 - $206 | 64% |
| Medicaid / KanCare | $68 - $7,633 | 64% |
| UnitedHealthcare | $69 - $103 | 65% |
| Veterans Administration Mill Bill | $72 | 67% |
| Medicare (plans) | $93 - $7,633 | 87% |
| Aetna | $103 - $5,420 | 96% |
| Devoted Health | $103 | 96% |
| Leon Health Inc | $103 | 96% |
| Tricare | $104 | 97% |
| Bristol Hospice- Miami Dade Llc | $105 | 98% |
| Catholic Hospice | $105 | 98% |
| Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc | $105 | 98% |
| Employer Direct Healthcare | $105 - $171 | 98% |
| Hospice Other | $105 | 98% |
| Ima Evalutations Inc | $105 | 98% |
| Odyssey Healthcare Of Marion County Dba Kindred Hospice | $105 | 98% |
| Opuscare Of South Fl | $105 | 98% |
| Seasons Hospice And Pallative Care Of Southern Florida Inc | $105 | 98% |
| Select Specialty Hospital | $105 | 98% |
| Veterans Administration Vaccn | $105 | 98% |
| Vitas Healthcare Hospice | $105 | 98% |
| Westchester General Hospital | $105 | 98% |
| Cigna | $108 - $3,817 | 101% |
| Healthsun Health Plans | $108 - $141 | 101% |
| Longevity Health Plan | $110 | 103% |
| Avmed Broad Network | $113 | 106% |
| Dimension Health Wc | $113 | 106% |
| Workers Compensation | $113 | 106% |
| Florida Pace Centers | $124 | 116% |
| Bright Health Management Commercial | $126 | 118% |
| Self Pay/Uninsured | $129 - $168 | 121% |
| Imagine Health | $144 | 135% |
| Naphcare Inc | $144 | 135% |
| Avmed Exchange | $183 | 171% |
| Ambetter / Centene | $194 | 182% |
| Oscar Health Plan Hix | $196 | 184% |
| Molina Marketplace Program Exchange | $199 | 186% |
| Auto Insurance | $209 | 196% |
| Avmed Select Network | $214 | 200% |
| Amerihealth Caritas Next Exchange | $225 | 211% |
| Bc/Bs Of Fl Miami Dade Blue Select | $258 | 242% |
| Bc/Bs Of Fl Health Options Hmo | $327 | 306% |
| Bc/Bs Of Fl Network Blue | $330 | 309% |
| Bc/Bs Myblue Hmo Hix | $337 | 316% |
| Bc/Bs Of Fl Simplyblue | $354 | 331% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $364 | 341% |
| Bc/Bs Of Fl Ppo | $387 | 362% |
| Liga Contra El Cancer | $2,000 | 1872% |
| Bc/Bs Of Fl Phs | $3,830 | 3586% |
| Magellan Behavioral Health | $4,580 | 4288% |
| Dimensions International | $4,962 | 4646% |
| First Health | $5,114 | 4788% |
| Dimension Health Ppo | $5,725 | 5360% |
| Beacon Health Strategies Commercial | $7,633 | 7146% |
| Commercial Non-Contracted | $7,633 | 7146% |
| Self Pay - Mcd Pending 100 Percent | $7,633 | 7146% |
| Single Case Agreement | $7,633 | 7146% |
| United Behavioral Health Psych | $7,633 | 7146% |