CMS Price Transparency Data

CT scan, pelvis

Facility: Community Hospital of Staunton

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,758
Cash Discount Price: $1,134
vs. Medicare Baseline: 16.46x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Community Hospital of Staunton is $1,758. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,134. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.46x the Medicare baseline. Located in 400 N Caldwell St, Staunton, IL.

Cash / Self-Pay

$1,134

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,758

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: $1,134 (1062%)

Insurance Median: $1,758 (1646%)

Cash: $1,134 (1062% of Medicare)

Ins. Median: $1,758 (1646% 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 1646% of the Medicare baseline (a markup of 1546%). 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
Tricare	$122 - $656	114%
Medicare (plans)	$125 - $680	117%
Clear Spring Health Ma	$129 - $690	121%
Medicaid / KanCare	$221 - $2,268	207%
Self Pay	$1,134	1062%
Cigna	$1,461	1368%
Blue Cross Blue Shield	$1,701 - $2,268	1593%
Healthlink	$1,701 - $1,928	1593%
Health Alliance Commercial	$1,815 - $2,268	1699%
Aetna	$1,837 - $2,268	1720%
Multiplan/Phcs	$1,928	1805%
Beech Street	$2,064	1932%
UnitedHealthcare	$2,268 - $2,959	2123%

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 $1,134.
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 Community Hospital of Staunton 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.