CMS Price Transparency Data

CT scan, pelvis

Facility: Thomas H Boyd Memorial Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $555
Cash Discount Price: $978
vs. Medicare Baseline: 5.20x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Thomas H Boyd Memorial Hospital is $555. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $978. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.20x the Medicare baseline. Located in 800 School St, Carrollton, IL.

Cash / Self-Pay

$978

Average discount available for prompt cash payment at this facility.

Insurance Median

$555

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: $978 (916%)

Insurance Median: $555 (520%)

Cash: $978 (916% of Medicare)

Ins. Median: $555 (520% 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 520% of the Medicare baseline (a markup of 420%). 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
Aetna	$137 - $1,110	128%
Blue Cross Blue Shield	$137 - $1,633	128%
Health Alliance Mcr Adv	$137 - $1,110	128%
UnitedHealthcare	$137 - $1,132	128%
Wellcare Mcr Adv-All Plans	$137 - $1,110	128%
Humana	$139 - $1,121	130%
Health Alliance-All Other Plans	$165 - $1,332	154%
Ambetter / Centene	$178 - $1,443	167%
Cigna	$192 - $1,552	180%
Multiplan-All Plans	$202 - $1,633	189%
Healthlink Hmo	$204 - $1,655	191%
Healthlink Il Only	$204 - $1,589	191%
Healthlink Ppo-All Other Plans	$231 - $1,872	216%
Hfn Zelis-All Plans	$245 - $1,981	229%
Meridian Hp Mcaid-All Plans	$555	520%
Molina Mcaid-All Plans	$555	520%

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 $978.
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 Thomas H Boyd Memorial 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.