CMS Price Transparency Data

CT scan, pelvis

Facility: Marion Communtiy Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $2,431
Cash Discount Price: $8,427
vs. Medicare Baseline: 22.76x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Marion Communtiy Hospital is $2,431. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,427. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 22.76x the Medicare baseline. Located in 1431 Sw 1St Ave, Ocala, FL.

Cash / Self-Pay

$8,427

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,431

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: $8,427 (7890%)

Insurance Median: $2,431 (2276%)

Cash: $8,427 (7890% of Medicare)

Ins. Median: $2,431 (2276% 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 2276% of the Medicare baseline (a markup of 2176%). 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 - $3,939	229%
Avmed	$856 - $1,863	801%
Aetna	$968 - $2,626	906%
Simply	$1,248 - $1,348	1168%
Molina Healthcare	$1,539 - $2,801	1441%
Sunshine State Health Plan	$2,066 - $2,232	1934%
Corvel Corporation	$2,300	2153%
Prime Health	$2,349	2199%
Careworks (Rockport Community)	$2,422	2268%
Marion County Schools	$2,422	2268%
Plotkin Health	$4,051 - $4,376	3793%
Prime Health Sheriff	$4,051 - $4,376	3793%
Multiplan	$6,320 - $6,827	5917%
Ppo Next	$6,887 - $7,440	6448%
Novanet	$7,292 - $7,877	6827%

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 $8,427.
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 Marion Communtiy 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.