CMS Price Transparency Data

CT scan, pelvis

Facility: Nemours Childrens Hospital, Florida

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,463
  • Cash Discount Price: $3,658
  • vs. Medicare Baseline: 13.70x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Nemours Childrens Hospital, Florida is $1,463. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,658. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.70x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.
Cash / Self-Pay
$3,658

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,463

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: $3,658 (3425%)
Insurance Median: $1,463 (1370%)
Cash: $3,658 (3425% of Medicare)
Ins. Median: $1,463 (1370% 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 1370% of the Medicare baseline (a markup of 1270%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Tricare $107 100%
Aetna $630 590%
Truli $729 - $1,463 683%
Avmed $795 744%
Florida Blue $810 - $2,231 758%
Evolutions Healthcare $927 868%
UnitedHealthcare $1,426 1335%
Cigna $1,443 1351%
Employers Health Network Fl $1,463 1370%
Integra Administrative Group $2,195 2055%
Global Medical Management $2,378 2226%
Prime Health Services $2,378 2226%
Star Healthcare Network $2,378 2226%
Velocity $2,744 2569%
First Health Network $2,853 2671%
Pnoa $2,926 2739%
Seminole Tribe Of Fl $2,926 2739%
Private Healthcare Systems $3,365 3150%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6535 Nemours Pkwy, Orlando, FL 32827
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens