CMS Price Transparency Data

CT scan, pelvis

Facility: HCA Florida Kendall Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $3,088
Cash Discount Price: $12,426
vs. Medicare Baseline: 28.91x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at HCA Florida Kendall Hospital is $3,088. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,426. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 28.91x the Medicare baseline. Located in 11750 Bird Rd, Miami, FL.

Cash / Self-Pay

$12,426

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,088

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: $12,426 (11634%)

Insurance Median: $3,088 (2891%)

Cash: $12,426 (11634% of Medicare)

Ins. Median: $3,088 (2891% 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 2891% of the Medicare baseline (a markup of 2791%). 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 - $5,592	229%
Aetna	$809 - $3,728	757%
Avmed	$845 - $6,213	791%
Freedom Health	$1,069 - $1,988	1001%
Optimum	$1,069	1001%
Simply Healthcare Plans	$1,615	1512%
Molina	$2,361 - $3,355	2210%
Corvel Corporation	$2,630	2462%
Health Sun Health Plan	$2,647	2478%
Careworks (Rockport)	$2,685	2514%
Prime Health	$2,685	2514%
Aids Healthcare	$2,734 - $14,911	2560%
Mmm Of Fl (Health Advantage Plan)	$2,858	2676%
United Ppo	$2,945	2757%
Sunshine State Health Plan	$3,231	3025%
Plotkin Health	$6,213	5817%
Prime Health Sherriff	$6,213	5817%
Medica Healthcare	$7,207	6747%
Multiplan	$9,320 - $10,562	8726%
Evernorth Bh	$9,941	9307%

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 $12,426.
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 Kendall 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.