CMS Price Transparency Data

CT scan, pelvis

Facility: Rush Memorial Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,019
Cash Discount Price: $2,394
vs. Medicare Baseline: 9.54x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Rush Memorial Hospital is $1,019. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,394. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.54x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$2,394

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,019

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: $2,394 (2241%)

Insurance Median: $1,019 (954%)

Cash: $2,394 (2241% of Medicare)

Ins. Median: $1,019 (954% 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 954% of the Medicare baseline (a markup of 854%). 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
UnitedHealthcare	$42 - $2,569	39%
Aetna	$48 - $2,954	45%
Caresource Mcr Adv	$48 - $996	45%
Humana	$48 - $2,954	45%
Blue Cross Blue Shield	$49 - $2,345	46%
Today'S Option Mcr Adv-All Plans	$49 - $1,025	46%
Viant Beech St Mcr Adv	$49 - $1,025	46%
My True Advantage - All Plans	$50 - $996	47%
Consumers Life Ins-All Plans	$52 - $2,890	49%
Caresource Marketplace-All Other Plans	$65 - $1,593	61%
Multiplan-All Plans	$67 - $2,987	63%
Encore Health Services-All Plans	$83 - $3,147	78%
Siho-All Plans	$83 - $2,954	78%
Phcs-All Plans	$100 - $2,569	94%
Cigna	$150 - $1,388	140%
Health Net	$150 - $946	140%
Coventry/First Health-All Plans	$209 - $2,890	196%
Sagamore-All Plans	$2,937 - $2,954	2750%
Community Health Alliance-All Plans	$3,001 - $3,019	2810%

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 $2,394.
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 Rush 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.