CMS Price Transparency Data

CT scan, pelvis

Facility: Memorial Hospital and Health Care Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $117
  • Cash Discount Price: $70
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Memorial Hospital and Health Care Center is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.10x the Medicare baseline. Located in 800 W 9Th St, Jasper, IN.
Cash / Self-Pay
$70

Average discount available for prompt cash payment at this facility.

Insurance Median
$117

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: $70 (66%)
Insurance Median: $117 (110%)
Cash: $70 (66% of Medicare)
Ins. Median: $117 (110% 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.

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 $40 - $238 37%
Aetna $48 - $438 45%
Caresource In Marketplace $48 - $153 45%
Humana $48 - $123 45%
Mdwise $48 - $125 45%
Mhs Hoosier Care Connect $48 - $125 45%
Tricare $48 - $123 45%
Chamber Care $49 46%
UnitedHealthcare $53 - $368 50%
Immergrun $57 - $147 53%
Ambetter / Centene $62 - $160 58%
Onecare $62 - $160 58%
Siho $62 - $160 58%
Noncontracted $76 - $196 71%
Patoka Valley $82 - $404 77%
Encore $84 - $405 79%
Encore Elite + $84 - $405 79%
Cigna $168 - $438 157%
Sagamore $168 - $438 157%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 W 9Th St, Jasper, IN 47546
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals