CMS Price Transparency Data

CT scan, pelvis

Facility: Jacksonville Memorial Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,645
Cash Discount Price: $2,804
vs. Medicare Baseline: 15.40x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Jacksonville Memorial Hospital is $1,645. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,804. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.40x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$2,804

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,645

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: $2,804 (2625%)

Insurance Median: $1,645 (1540%)

Cash: $2,804 (2625% of Medicare)

Ins. Median: $1,645 (1540% 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 1540% of the Medicare baseline (a markup of 1440%). 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
Blue Cross Blue Shield	$117 - $2,971	110%
Tricare	$123 - $542	115%
Coventry	$124 - $468	116%
Health Alliance	$124 - $2,020	116%
Humana	$124 - $2,534	116%
Medicare (plans)	$124 - $468	116%
UnitedHealthcare	$130 - $2,139	122%
Medicaid / KanCare	$209	196%
Molina Healthcare	$209	196%
Corvel/Corcare	$922 - $984	863%
Illinois Workers Compensation	$990 - $1,224	927%
Healthlink	$1,050 - $2,525	983%
Commercial Workers Compensation	$1,163	1089%
Health Alliance Mh Employee Plan	$1,213 - $1,367	1136%
Current Health Network	$1,450 - $2,228	1358%
6 Degrees Health	$1,582 - $1,783	1481%
Hope Trust	$1,582 - $1,783	1481%
Hst	$1,582 - $1,783	1481%
Cigna	$1,827 - $2,059	1711%
Aetna	$1,843 - $2,377	1725%
Phcs/Multiplan	$2,373 - $2,674	2222%
Hfn	$2,505 - $2,822	2345%
Liability	$2,637 - $2,971	2469%

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 $2,804.
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 Jacksonville 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.