CMS Price Transparency Data

CT scan, pelvis

Facility: HCA Florida North Florida Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $4,868
Cash Discount Price: $15,704
vs. Medicare Baseline: 45.58x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at HCA Florida North Florida Hospital is $4,868. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,704. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 45.58x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.

Cash / Self-Pay

$15,704

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,868

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: $15,704 (14703%)

Insurance Median: $4,868 (4558%)

Cash: $15,704 (14703% of Medicare)

Ins. Median: $4,868 (4558% 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 4558% of the Medicare baseline (a markup of 4458%). 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 - $7,067	229%
Avmed	$857 - $7,852	802%
Aetna	$968 - $4,711	906%
Simply	$2,418	2264%
Corvel Corporation	$2,548	2386%
Prime Health	$2,602	2436%
Careworks (Rockport Community)	$2,682	2511%
Molina Healthcare	$2,984 - $5,025	2794%
Sunshine State Health Plan	$4,004	3749%
Plotkin Health	$7,852	7351%
Prime Health Sheriff	$7,852	7351%
Corizon Phs	$9,422	8821%
Multiplan	$12,249 - $13,348	11468%
Evernorth	$12,563	11762%
Evolutions Healthcare	$13,348	12497%
Ppo Next	$13,348	12497%
Novanet	$14,133	13232%
Beacon Health Options	$15,704	14703%

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 $15,704.
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 North Florida 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.