CMS Price Transparency Data

CT scan, pelvis

Facility: Dukes Memorial Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,080
  • Cash Discount Price: $1,418
  • vs. Medicare Baseline: 10.11x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Dukes Memorial Hospital is $1,080. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,418. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.11x the Medicare baseline. Located in 275 W 12Th St, Peru, IN.
Cash / Self-Pay
$1,418

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,080

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: $1,418 (1328%)
Insurance Median: $1,080 (1011%)
Cash: $1,418 (1328% of Medicare)
Ins. Median: $1,080 (1011% 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 1011% of the Medicare baseline (a markup of 911%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Veterans Eval Services $98 92%
Caresource $202 - $262 189%
Us Department Of Labor $215 201%
Blue Cross Blue Shield $262 - $864 245%
Humana $262 - $531 245%
Managed Health Services $262 - $1,080 245%
Medicaid / KanCare $262 245%
Mhs $262 245%
UnitedHealthcare $262 - $1,328 245%
One Call Wc $275 257%
Department Of Veterans Affairs $500 468%
Tricare $500 468%
Iu Health Plan $531 497%
Medicare (plans) $531 497%
Node Va $540 - $1,304 506%
Aetna $542 - $1,285 507%
Node Devoted Health Mcr Adv $542 507%
In Dept Of Correction $562 526%
Miami County Sheriffs Department $562 526%
Node Pphp Mcr Adv $567 531%
Sagamore Health Network $603 - $1,496 565%
Lutheran Advanced Network $810 758%
Lutheran Three Rivers Preferred Plus 150 $810 758%
Node Lutheran Preferred Fixed 2 $810 758%
Lutheran Preferred $859 - $2,160 804%
Align Network $864 809%
Lutheran Three Rivers Preferred Plus 175 $945 885%
Encore Work Comp In $972 910%
Prime Health Services $972 - $2,025 910%
Partners Direct Health Llc $1,026 961%
Lutheran Northwest Health Preferred $1,080 1011%
Three Rivers Preferred Plus $1,080 1011%
Work Comp $1,080 1011%
Physicians Health Plan $1,086 - $1,259 1017%
Cigna $1,145 - $2,700 1072%
Three Rivers Preferred $1,215 1138%
Php Freedom $1,247 1167%
Encore Kba Epo $1,296 1213%
Amish Aid $1,350 1264%
Encore Ppo $1,350 1264%
Self Pay $1,350 - $1,485 1264%
Encore Kba Ppo $1,620 1517%
Consumer Life $1,674 1567%
First Health $2,160 2022%
Multiplan $2,187 2048%
Encore Health Network $2,214 2073%
Advantage Health Solutions $2,241 2098%
Encore $2,430 2275%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 275 W 12Th St, Peru, IN 46970
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals