CMS Price Transparency Data

CT scan, pelvis

Facility: St Joseph Health System, LLC

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,489
  • Cash Discount Price: $1,290
  • vs. Medicare Baseline: 13.94x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at St Joseph Health System, LLC is $1,489. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,290. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.94x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.
Cash / Self-Pay
$1,290

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,489

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: $1,290 (1208%)
Insurance Median: $1,489 (1394%)
Cash: $1,290 (1208% of Medicare)
Ins. Median: $1,489 (1394% 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 1394% of the Medicare baseline (a markup of 1294%). 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 - $2,237 102%
Blue Cross Blue Shield $109 - $1,193 102%
Humana $109 - $262 102%
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%
Lutheran Network $166 - $1,810 155%
Encore Work Comp In $199 186%
Prime Health Services $199 - $2,468 186%
Work Comp $221 207%
Caresource $262 245%
Medicaid / KanCare $262 245%
Encore Kba Epo $265 248%
Spreemo $300 281%
Encore Kba Ppo $332 311%
Php Freedom Network $386 361%
Php $436 - $1,315 408%
Sagamore $603 565%
Amish Aid $781 - $790 731%
Self Pay $781 - $1,810 731%
Encore Ppo $816 - $2,961 764%
Lutheran Preferred $928 - $1,974 869%
Cigna $1,052 - $3,290 985%
Three Rivers $1,465 - $1,480 1372%
Multiplan $2,247 - $2,566 2104%
First Health $2,442 - $2,468 2286%
Align Network $2,605 - $2,632 2439%
Frontpath Health Coalition $2,605 - $2,632 2439%
Advantage Health Solutions $2,702 - $2,731 2530%
Allied Benefit Systems $2,930 - $2,961 2743%
Medical Mutual Of Ohio $3,256 - $3,290 3048%
Parkview Healthplan Services $3,256 - $3,290 3048%
Value Options $3,256 - $3,290 3048%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 702 Van Buren St., Fort Wayne, IN 46802
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals