CMS Price Transparency Data

CT scan, pelvis

Facility: Grady Memorial Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $111
Cash Discount Price: $4,157
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Grady Memorial Hospital is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,157. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.04x the Medicare baseline. Located in 80 Jesse Hill, Jr Drive Se, Atlanta, GA.

Cash / Self-Pay

$4,157

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $4,157 (3892%)

Insurance Median: $111 (104%)

Cash: $4,157 (3892% of Medicare)

Ins. Median: $111 (104% 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.

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
Amerigroup	$48 - $676	45%
Caresource	$48 - $620	45%
Peach State	$48 - $620	45%
Aetna	$50 - $1,850	47%
Ambetter / Centene	$50 - $615	47%
Blue Cross Blue Shield	$50 - $3,326	47%
Cigna	$50 - $2,459	47%
Humana	$50 - $106	47%
Kaiser	$50 - $3,151	47%
Medicare (plans)	$50 - $106	47%
UnitedHealthcare	$50 - $2,993	47%
Vaccn	$50 - $106	47%
Wellcare	$50 - $106	47%
Clear Spring Health	$52 - $111	49%
Clover	$52 - $111	49%
Usp Naphcare	$55 - $2,494	51%
Oscar Health	$70 - $2,702	66%
Multiplan	$3,201	2997%

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 $4,157.
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 Grady Memorial 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.