CMS Price Transparency Data

CT scan, pelvis

Facility: Decatur County Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,181
  • Cash Discount Price: $1,181
  • vs. Medicare Baseline: 11.06x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Decatur County Hospital is $1,181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,181. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.06x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$1,181

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,181

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: $1,181 (1106%)
Insurance Median: $1,181 (1106%)
Cash: $1,181 (1106% of Medicare)
Ins. Median: $1,181 (1106% 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 1106% of the Medicare baseline (a markup of 1006%). 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
Blue Cross Blue Shield $472 442%
Wellmark Hmo $480 449%
Wellmark Ppo - All Other Plans $529 495%
Champva -All Plans $664 622%
Everystep Hospice-All Plans $768 719%
Aetna $797 - $1,166 746%
Tricare $797 746%
UnitedHealthcare $886 - $1,255 830%
Benefit Admin System-All Plans $959 898%
Humana $1,077 1008%
Meritain Health-All Plans $1,077 1008%
Misc Commercial-All Plans $1,077 1008%
All Savers-All Plans $1,107 1036%
Allied Benefit System-All Plans $1,107 1036%
American Family Ins Grp-All Plans $1,107 1036%
Rural Carrier Benefit Plan-All Plans $1,137 1065%
Christian Healthcare -All Plans $1,181 1106%
Medica-All Other Plans $1,181 1106%
Golden Rule-All Plans $1,255 1175%
Ntca The Rural Broadband-All Plans $1,255 1175%
Cigna $1,269 1188%
Medical Mutual-All Plans $1,299 1216%
Farm Bureau Financial-All Other Plans $1,328 1243%
Farm Bureau Property And Ca $1,328 1243%
Medi Share-All Plans $1,343 1257%
Uhss-All Plans $1,343 1257%
Health Partners-All Plans $1,358 1271%
Lewermark-All Plans $1,402 1313%
Mail Handlers Benefit-All Plans $1,446 1354%
Midlands Choice-All Plans $1,446 1354%
Priority Health-All Plans $1,476 1382%
Iowa Total Care Mcaid-All Plans $1,506 1410%
Amerigroup Mcaid-All Plans $1,550 1451%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals