CMS Price Transparency Data

CT scan, pelvis

Facility: Palos Community Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $2,465
Cash Discount Price: $2,157
vs. Medicare Baseline: 23.08x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Palos Community Hospital is $2,465. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,157. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 23.08x the Medicare baseline. Located in 12251 South 80Th Avenue, Palos Heights, IL.

Cash / Self-Pay

$2,157

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,465

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: $2,157 (2019%)

Insurance Median: $2,465 (2308%)

Cash: $2,157 (2019% of Medicare)

Ins. Median: $2,465 (2308% 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 2308% of the Medicare baseline (a markup of 2208%). 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	$493 - $3,081	462%
Aetna	$662 - $3,081	620%
Carelon Behavioral Health [159]	$1,540	1442%
Healthlink [125]	$1,540 - $3,081	1442%
Magellan Behavioral Hlth [136]	$1,849	1731%
The Alliance [1703]	$1,979	1853%
First Health Plan [6034]	$2,311	2164%
Beechstreet [176]	$2,465	2308%
Cigna	$2,465 - $3,081	2308%
Health'S Finest Network [126]	$2,619	2452%
Galaxy Health Network [220]	$3,081	2885%
Global Excel [1712]	$3,081	2885%
Health Alliance [181]	$3,081	2885%
Multiplan/Phcs [142]	$3,081	2885%
UnitedHealthcare	$3,081	2885%

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 $2,157.
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 Palos Community 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.