CMS Price Transparency Data

CT scan, pelvis

Facility: Memorial Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,783
Cash Discount Price: $2,971
vs. Medicare Baseline: 16.69x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Memorial Medical Center is $1,783. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,971. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.69x the Medicare baseline. Located in 701 N First St, Springfield, IL.

Cash / Self-Pay

$2,971

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,783

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: $2,971 (2782%)

Insurance Median: $1,783 (1669%)

Cash: $2,971 (2782% of Medicare)

Ins. Median: $1,783 (1669% 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 1669% of the Medicare baseline (a markup of 1569%). 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
Veterans Administration	$79	74%
Blue Cross Blue Shield	$103 - $2,971	96%
Aetna	$110 - $2,258	103%
Health Alliance	$110 - $1,931	103%
Medicare (plans)	$110 - $2,971	103%
Tricare	$110	103%
UnitedHealthcare	$110 - $1,842	103%
Humana	$116 - $1,783	109%
Medicaid / KanCare	$134	125%
Molina	$137	128%
Healthlink	$512 - $1,872	479%
Cigna	$1,041	975%
Commercial Workers Compensation	$1,087	1018%
Illinois Workers Compensation	$1,144	1071%
Current Health Network Ppo	$1,337	1252%
Phcs/Multiplan	$1,604 - $1,783	1502%
6 Degrees Health	$1,783	1669%
Hopetrust	$1,783	1669%
Hst	$1,783	1669%
Magellan	$1,783	1669%
Consociate	$1,931	1808%
Hfn	$1,931	1808%
Preferred Plan	$2,228	2086%
Soi Mcfarland	$2,228	2086%
Soi Rushville	$2,228	2086%
Corvel	$2,377	2225%
Methodist First Choice	$2,377	2225%
Mutual Medical Plans	$2,525	2364%
Liability	$2,971	2782%

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 $2,971.
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 Memorial 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.