CMS Price Transparency Data

CT scan, pelvis

Facility: Massac Memorial Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,394
Cash Discount Price: $1,841
vs. Medicare Baseline: 13.05x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Massac Memorial Hospital is $1,394. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,841. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.05x the Medicare baseline. Located in 28 Chick Street, Po Box 850, Metropolis, IL.

Cash / Self-Pay

$1,841

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,394

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: $1,841 (1724%)

Insurance Median: $1,394 (1305%)

Cash: $1,841 (1724% of Medicare)

Ins. Median: $1,394 (1305% 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 1305% of the Medicare baseline (a markup of 1205%). 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	$240 - $2,151	225%
Blue Cross Blue Shield	$240 - $2,525	225%
Medicaid / KanCare	$240	225%
Molina Ky Mcaid	$240	225%
Healthlink Hmo	$1,282	1200%
Healthlink Ppo-All Other Plans	$1,350	1264%
Chesi Op Only-All Plans	$1,394	1305%
Health Alliance Mcare Adv	$1,394	1305%
Humana	$1,394	1305%
Health Alliance Exchange	$1,710	1601%
Health Alliance-All Other Plans	$1,710	1601%
Prime Health Services-All Plans	$1,710	1601%
Cigna	$2,167	2029%
UnitedHealthcare	$2,209	2068%
Multiplan-All Plans	$2,367	2216%

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 $1,841.
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 Massac 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.