CMS Price Transparency Data

CT scan, pelvis

Facility: Warner Hospital and Health Services

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $2,060
Cash Discount Price: $2,528
vs. Medicare Baseline: 19.29x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Warner Hospital and Health Services is $2,060. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,528. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 19.29x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$2,528

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,060

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: $2,528 (2367%)

Insurance Median: $2,060 (1929%)

Cash: $2,528 (2367% of Medicare)

Ins. Median: $2,060 (1929% 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 1929% of the Medicare baseline (a markup of 1829%). 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	$405 - $2,165	379%
Blue Cross Blue Shield	$405 - $2,496	379%
Harmony Hp Mcaid-All Plans	$405	379%
Medicaid / KanCare	$405	379%
Meridian Hp-All Plans	$405	379%
Molina-All Other Plans	$405	379%
Health Alliance Med Adv	$1,029 - $1,044	963%
Humana	$1,029 - $2,165	963%
Molina Mcr/Mcd Dual	$1,029 - $1,044	963%
UnitedHealthcare	$1,029 - $2,165	963%
Wellcare Mcr Adv-All Plans	$1,029 - $1,044	963%
Healthlink Hmo	$1,957 - $1,986	1832%
City Of Clinton (Employees Serv)-All Plans	$2,007 - $2,037	1879%
Cigna	$2,082 - $2,114	1949%
Caterpillar-All Plans	$2,133 - $2,165	1997%
Multiplan Phcs-All Plans	$2,133 - $2,165	1997%
Health Alliance-All Other Plans	$2,208 - $2,241	2067%
Healthlink Ppo/Work Comp-All Other Plans	$2,208 - $2,241	2067%
Consociate Care Ppo-All Plans	$2,258 - $2,292	2114%
Hfn Ppo/Epo-All Plans	$2,258 - $2,292	2114%
Three Rivers-All Plans	$2,384 - $2,419	2232%

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 $2,528.
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 Warner Hospital and Health Services 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.