CMS Price Transparency Data

CT scan, pelvis

Facility: Loring Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,290
Cash Discount Price: $1,358
vs. Medicare Baseline: 12.08x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Loring Hospital is $1,290. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,358. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.08x the Medicare baseline. Located in 211 Highland Avenue Po Box 217, Sac City, IA.

Cash / Self-Pay

$1,358

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,290

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: $1,358 (1271%)

Insurance Median: $1,290 (1208%)

Cash: $1,358 (1271% of Medicare)

Ins. Median: $1,290 (1208% 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 1208% of the Medicare baseline (a markup of 1108%). 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
Meritain	$340	318%
Bas	$509	477%
Aetna	$645 - $1,698	604%
Auxiant	$849	795%
Blue_Cross	$1,019 - $1,698	954%
Champva	$1,019	954%
Health_Partners	$1,019	954%
Admin_Concepts	$1,087	1018%
UnitedHealthcare	$1,189 - $1,698	1113%
Va	$1,274	1193%
Champus	$1,290	1208%
Humana	$1,494 - $1,698	1399%
Healthscope	$1,528	1431%
Midlands_Choice	$1,596	1494%
Cigna	$1,630	1526%

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 $1,358.
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 Loring 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.