CMS Price Transparency Data

CT scan, pelvis

Facility: HCA Florida Orange Park Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $4,663
Cash Discount Price: $18,288
vs. Medicare Baseline: 43.66x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at HCA Florida Orange Park Hospital is $4,663. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18,288. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 43.66x the Medicare baseline. Located in 2001 Kingsley Ave, Orange Park, FL.

Cash / Self-Pay

$18,288

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,663

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: $18,288 (17122%)

Insurance Median: $4,663 (4366%)

Cash: $18,288 (17122% of Medicare)

Ins. Median: $4,663 (4366% 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 4366% of the Medicare baseline (a markup of 4266%). 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 - $8,230	229%
Aetna	$716 - $5,486	670%
Avmed	$825 - $1,863	772%
Optimum Healthcare	$1,536	1438%
Corvel Corporation	$2,412	2258%
Prime Health	$2,463	2306%
Simply Healthcare	$2,816	2636%
Positive Healthcare	$4,023	3767%
Sunshine State Health Plan	$4,663	4366%
Molina Healthcare	$4,938	4623%
Medicare (plans)	$8,230	7705%
Plotkin Health	$9,144	8561%
Multiplan	$14,265 - $15,545	13355%
Evernorth	$14,630	13697%
Evolutions Healthcare	$14,630 - $15,545	13697%
Ppo Next	$15,545	14554%
Novanet	$16,459	15410%

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 $18,288.
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 Orange Park 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.