CMS Price Transparency Data

CT scan, pelvis

Facility: Lutheran Hospital of Indiana

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,003
  • Cash Discount Price: $1,006
  • vs. Medicare Baseline: 9.39x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Lutheran Hospital of Indiana is $1,003. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,006. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.39x the Medicare baseline. Located in 7950 W Jefferson Blvd, Fort Wayne, IN.
Cash / Self-Pay
$1,006

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,003

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: $1,006 (942%)
Insurance Median: $1,003 (939%)
Cash: $1,006 (942% of Medicare)
Ins. Median: $1,003 (939% 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 939% of the Medicare baseline (a markup of 839%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
UnitedHealthcare $98 - $1,529 92%
Veterans Eval Services $98 92%
Tricare $105 98%
Aetna $109 - $1,643 102%
Blue Cross Blue Shield $109 - $1,280 102%
Humana $109 - $262 102%
Iu Health Plan $109 102%
Managed Health Services $109 - $262 102%
Medicare (plans) $109 102%
Department Of Veterans Affairs $111 104%
Node Devoted Health Mcr Adv $111 104%
Node Hospice Non Par Agree $111 104%
Node Va $111 104%
In Dept Of Correction $115 108%
Node Pphp Mcr Adv $116 109%
Us Department Of Labor $138 129%
Lutheran Advanced Network $166 155%
Node Lutheran Network $166 - $194 155%
Node Lutheran Preferred Fixed 2 $166 155%
Align Network $177 166%
Encore Work Comp In $199 186%
Prime Health Services $199 - $2,588 186%
Lutheran Network $221 - $1,726 207%
Care Source $262 245%
Medicaid / KanCare $262 245%
Node Encore Kba Epo $265 248%
One Call Care Diagnostics $275 257%
Spreemo $300 281%
Ky Work Comp $305 - $870 286%
Node Encore Kba Ppo $332 311%
Amish Aid $363 - $1,035 340%
Lutheran Preferred Network $363 - $2,071 340%
Self Pay $363 - $1,242 340%
Cigna $391 - $1,253 366%
Php Freedom Network $410 384%
Physicians Health Plan Of Northern Indiana $436 - $1,362 408%
Lutheran Preferred $484 - $1,380 453%
Sagamore $551 - $1,660 516%
Encore Ppo $816 764%
Multiplan $883 - $2,864 827%
Encore Health Network $991 - $3,106 928%
Advantage Health Solutions $1,003 - $2,864 939%
Allied Benefit Systems $1,088 - $3,106 1019%
Evolutions $1,088 - $3,106 1019%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7950 W Jefferson Blvd, Fort Wayne, IN 46804
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals