CMS Price Transparency Data

CT scan, pelvis

Facility: Eastern Idaho Regional Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $837
Cash Discount Price: $1,615
vs. Medicare Baseline: 7.84x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Eastern Idaho Regional Medical Center is $837. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,615. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.84x the Medicare baseline. Located in 3100 Channing Way, Idaho Falls, ID.

Cash / Self-Pay

$1,615

Average discount available for prompt cash payment at this facility.

Insurance Median

$837

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: $1,615 (1512%)

Insurance Median: $837 (784%)

Cash: $1,615 (1512% of Medicare)

Ins. Median: $837 (784% 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 784% of the Medicare baseline (a markup of 684%). 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
Blue Cross Blue Shield	$41 - $1,534	38%
Molina	$41 - $64	38%
Interwest Health	$151 - $1,454	141%
Regence	$225	211%
United	$245 - $934	229%
Select Health	$489	458%
Select Health Ichn Brightpath	$489 - $546	458%
Select Health Idaho (Eirmc Only)	$515	482%
Aetna	$636 - $787	595%
Doug Andrus Distributing	$646	605%
University Of Utah	$678	635%
Mountain Health Co-Op	$808 - $1,211	756%
Pacificsource Health	$866	811%
Cigna	$888	831%
First Choice Health Of Washington	$969	907%
Moda	$1,006	942%
Dmba	$1,040	974%
Prime Health	$1,211 - $1,373	1134%
Geha Ppo Usa	$1,292	1210%
Humana	$1,357	1270%
Multiplan	$1,357 - $1,454	1270%
First Choice Of The Midwest	$1,454	1361%
St. John'S Health Network	$1,454	1361%
Coventry First Health	$1,470	1376%
Shashone-Bannock Tribal Health	$1,615	1512%

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 $1,615.
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 Eastern Idaho Regional Medical Center 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.