CMS Price Transparency Data

CT scan, pelvis

Facility: Viera Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,192
Cash Discount Price: $529
vs. Medicare Baseline: 11.16x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Viera Hospital is $1,192. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $529. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.16x the Medicare baseline. Located in 8745 N Wickham Rd, Melbourne, FL.

Cash / Self-Pay

$529

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,192

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: $529 (495%)

Insurance Median: $1,192 (1116%)

Cash: $529 (495% of Medicare)

Ins. Median: $1,192 (1116% 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 1116% of the Medicare baseline (a markup of 1016%). 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
Molina Healthcare	$67 - $2,370	63%
Health First Health Plan	$69 - $631	65%
Humana	$69 - $2,116	65%
Aetna	$71 - $2,328	66%
Amerigroup	$71 - $2,116	66%
Sunshine Health Plan	$71 - $2,222	66%
UnitedHealthcare	$71 - $2,116	66%
Corizon Health	$109	102%
Florida Healthcare Plans	$669	626%
Cigna	$815 - $872	763%
Disney Cruise Line	$1,270	1189%
Prime Heath Services, Inc.	$1,587	1486%
Multiplan	$1,693	1585%
Florida Blue	$2,071 - $2,172	1939%

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 $529.
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 Viera 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.