CMS Price Transparency Data

CT scan, pelvis

Facility: Fayette County Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $210
Cash Discount Price: $1,618
vs. Medicare Baseline: 1.97x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Fayette County Hospital is $210. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,618. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.97x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.

Cash / Self-Pay

$1,618

Average discount available for prompt cash payment at this facility.

Insurance Median

$210

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: $1,618 (1515%)

Insurance Median: $210 (197%)

Cash: $1,618 (1515% of Medicare)

Ins. Median: $210 (197% 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.

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	$20 - $2,029	19%
Blue Cross Blue Shield	$20 - $2,470	19%
Illinicare - All Plans	$20 - $210	19%
Medicaid / KanCare	$20 - $210	19%
Meridian-All Plans	$20 - $210	19%
Health Alliance Mcare	$50 - $941	47%
Healthlink Mcr Adv	$50 - $941	47%
Cigna	$58 - $2,206	54%
Coventry/Ghp-All Plans	$67 - $1,912	63%
Multiplan - All Plans	$92 - $2,500	86%
Health Alliance - All Other Plans	$100 - $2,429	94%
UnitedHealthcare	$244 - $2,441	228%
Healthlink Hmo	$253 - $2,059	237%
Healthlink Ppo - All Other Plans	$253 - $2,353	237%
Humana	$941	881%

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 $1,618.
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 Fayette County 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.