CMS Price Transparency Data

CT scan, pelvis

Facility: Adventist Health Castle

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,144
Cash Discount Price: $534
vs. Medicare Baseline: 10.71x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Adventist Health Castle is $1,144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $534. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.71x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.

Cash / Self-Pay

$534

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,144

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: $534 (500%)

Insurance Median: $1,144 (1071%)

Cash: $534 (500% of Medicare)

Ins. Median: $1,144 (1071% 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 1071% of the Medicare baseline (a markup of 971%). 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
Kfh Mcr Adv	$124	116%
Medicare (plans)	$124	116%
Ohana Health Plan - All Plans	$126	118%
Devoted Hlth Mcr Adv - All Plans	$130	122%
UnitedHealthcare	$195	183%
Alohacare Quest Mcaid - All Other Plans	$357 - $476	334%
Hmsa Hmo	$389	364%
Hmsa Ppo - All Other Plans	$389	364%
Pacific Admin Ppo - All Plans	$909 - $1,212	851%
Kfh - All Other Plans	$1,001 - $1,334	937%
Hwmg/Hmaa - All Plans	$1,052 - $1,403	985%
Mdx Hawaii Ppo - All Plans	$1,142 - $1,522	1069%
Health Alliance - All Plans	$1,144 - $1,525	1071%
Uni Health Alliance - All Plans	$1,334 - $1,778	1249%
First Health Ppo - All Plans	$1,344 - $1,792	1258%
Medicaid / KanCare	$1,430 - $1,906	1339%
State Of Hi Nonprofit - All Plans	$2,502 - $3,336	2342%

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 $534.
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 Adventist Health Castle 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.