CMS Price Transparency Data

CT scan, pelvis

Facility: Kapiolani Medical Center for Women & Children

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $363
Cash Discount Price: $1,195
vs. Medicare Baseline: 3.40x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Kapiolani Medical Center for Women & Children is $363. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,195. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.40x the Medicare baseline. Located in 1319 Punahou Street, Honolulu, HI.

Cash / Self-Pay

$1,195

Average discount available for prompt cash payment at this facility.

Insurance Median

$363

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: $1,195 (1119%)

Insurance Median: $363 (340%)

Cash: $1,195 (1119% of Medicare)

Ins. Median: $363 (340% 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 340% of the Medicare baseline (a markup of 240%). 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
Alohacare	$106 - $117	99%
Hmsa	$106 - $389	99%
Kaiser	$106 - $1,752	99%
Mdx	$106 - $134	99%
Devoted	$112	105%
Ohana	$128 - $581	120%
Hwmg/Hmaa	$223	209%
UnitedHealthcare	$292	273%
Pac Admin	$352	330%
Uha	$375 - $996	351%
Mimoh	$1,394 - $1,493	1305%
Calvos	$1,493	1398%
Hcha	$1,593	1491%
Multiplan	$1,593 - $1,692	1491%
Verdegard	$1,593	1491%
Mccp	$1,692	1584%
Coventry	$1,792	1678%

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 $1,195.
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 Kapiolani Medical Center for Women & Children 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.