CMS Price Transparency Data

CT scan, pelvis

Facility: Trinity - Bettendorf

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $122
Cash Discount Price: $348
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Trinity - Bettendorf is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $348. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.14x the Medicare baseline. Located in 4500 Utica Ridge Road, Bettendorf, IA.

Cash / Self-Pay

$348

Average discount available for prompt cash payment at this facility.

Insurance Median

$122

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: $348 (326%)

Insurance Median: $122 (114%)

Cash: $348 (326% of Medicare)

Ins. Median: $122 (114% 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
Aetna	$48 - $401	45%
Ambetter / Centene	$48 - $157	45%
Blue Cross Blue Shield	$48 - $306	45%
Health Alliance	$48 - $122	45%
Humana	$50 - $128	47%
Meridian Health Plan	$50 - $128	47%
UnitedHealthcare	$50 - $273	47%
Amerigroup	$92	86%
Iowa Total Care	$92	86%
Wellmark Uph Self-Funded	$98 - $260	92%
Cigna	$101 - $1,232	95%
Health Partners Open Network	$105 - $286	98%
Medica Exchange Inspire	$818	766%
Medica Exchange Insure	$916	858%

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 $348.
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 Trinity - Bettendorf 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.