CMS Price Transparency Data

CT scan, pelvis

Facility: Memorial Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $2,723
Cash Discount Price: $2,434
vs. Medicare Baseline: 25.49x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Memorial Hospital is $2,723. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,434. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 25.49x the Medicare baseline. Located in 1454 N County Road 2050 E, Carthage, IL.

Cash / Self-Pay

$2,434

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,723

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: $2,434 (2279%)

Insurance Median: $2,723 (2549%)

Cash: $2,434 (2279% of Medicare)

Ins. Median: $2,723 (2549% 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 2549% of the Medicare baseline (a markup of 2449%). 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	$558 - $3,042	522%
Consociate	$558 - $3,042	522%
Humana	$805 - $3,042	754%
Blue Cross Blue Shield	$852 - $3,042	798%
Cigna	$852 - $3,042	798%
Health Alliance	$852 - $3,042	798%
Meridian	$852 - $3,042	798%
Molina	$852 - $3,042	798%
UnitedHealthcare	$852 - $3,042	798%
First Health Network	$1,374 - $2,707	1286%
Healthlink	$2,586 - $3,042	2421%
Private Healthcare Systems	$2,586	2421%
Integrated Health Plan	$2,677	2506%
Health Dynamics	$2,738	2563%
Health Payors Org	$2,738	2563%
Iowa Health Solutions	$2,738	2563%
Multiplan	$2,738	2563%
Preferred Plan Inc	$2,738	2563%
Three Rivers Provider Network	$2,738	2563%
Health First Network	$2,768	2592%
Pponext	$2,768	2592%
Corvel	$2,890	2706%

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 $2,434.
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 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.