CMS Price Transparency Data

CT scan, pelvis

Facility: Portneuf Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,234
  • Cash Discount Price: $823
  • vs. Medicare Baseline: 11.55x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Portneuf Medical Center is $1,234. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $823. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.55x the Medicare baseline. Located in 777 Hospital Way, Pocatello, ID.
Cash / Self-Pay
$823

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,234

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: $823 (771%)
Insurance Median: $1,234 (1155%)
Cash: $823 (771% of Medicare)
Ins. Median: $1,234 (1155% 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 1155% of the Medicare baseline (a markup of 1055%). 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
Aetna $282 264%
Healthscope Benefits [2290] $282 264%
UnitedHealthcare $282 - $1,234 264%
Black Lung [6055] $562 526%
Employee Benefit Management Services [2445] $562 - $823 526%
Healthcare Highways [2210] $562 - $1,302 526%
Lucent Health [6000] $562 526%
Moda Health [6100] $562 526%
Oncology Patient Assistance Programs [2295] $562 526%
Pending Ssi [1616] $562 526%
Web Tpa [2115] $562 526%
Pacific Source Health Plans [2850] $788 738%
Liberty Health Share Lhs/Medcost Solutions Llc [2400] $823 771%
Medishare Christian Care [1645] $823 771%
Multiplan [1680] $919 - $1,302 860%
Cigna $1,009 945%
First Health [1375] $1,131 1059%
Selecthealth [3740] $1,163 - $1,234 1089%
Geha [1415] $1,234 1155%
Humana $1,234 1155%
Administrative Concepts [1005] $1,302 1219%
Healthfirst [2395] $1,302 1219%
Healthnet [1495] $1,302 1219%
Hometown Health [2155] $1,302 1219%
Mayo Clinic Health Solutions [2280] $1,302 1219%
Meritain Health [1655] $1,302 1219%
Mutual Of Omaha [1685] $1,302 1219%
National Association Of Letter Carriers [1695] $1,302 1219%
New Era Life Insurance Company [1705] $1,302 1219%
Pan American Life Insurance Co [1770] $1,302 1219%
Pba [1775] $1,302 1219%
Phcs [1780] $1,302 1219%
Planned Administrators Inc [2360] $1,302 1219%
Trustmark [2030] $1,302 1219%
Ut Id Teamsters [3760] $1,302 1219%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 777 Hospital Way, Pocatello, ID 83201
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals