CT scan, pelvis
Facility: Saint John Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $103
- Cash Discount Price: $98
- vs. Medicare Baseline: 0.96x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $60 | 56% |
| UnitedHealthcare | $91 - $138 | 85% |
| Healthy Blue | $93 - $103 | 87% |
| Celtic | $93 - $158 | 87% |
| Tricare | $98 | 92% |
| Midland Care Connection | $98 | 92% |
| Aetna | $98 - $207 | 92% |
| Cigna | $98 | 92% |
| Medicare (plans) | $98 | 92% |
| Kansas Superior Select | $100 | 94% |
| Comp Alliance Workers Comp | $134 | 125% |
| Employer Direct Healthcare | $138 | 129% |
| Well Path | $138 | 129% |
| Corizon | $138 | 129% |
| Oha Networks | $145 | 136% |
| Centurion | $148 | 139% |
| Worker Compensation | $149 | 140% |
| Naphcare | $153 | 143% |
| Blue Cross Blue Shield | $228 - $480 | 213% |
Consumer Guidance & Cost Commentary
For the CT scan of the pelvis at Saint John Hospital in Leavenworth, KS, the cash price is $98.00, which is significantly lower than the facility's gross charge of $1,719.00. While many insurance plans negotiate rates ranging from $60 to $480, the cash rate remains the lowest option available. Patients with high-deductible plans or those without insurance may find it financially advantageous to pay the cash price directly, as it avoids the administrative overhead and potential markups often embedded in negotiated rates. It is important to note that while the cash rate is fixed, hospitals frequently offer additional discounts for self-pay or prompt-pay arrangements, so patients should explicitly ask about these incentives before scheduling to ensure they are receiving the best possible price.
The facility's pricing is benchmarked against Medicare, which sets a baseline rate of $106.81 for this procedure. The cash price of $98.00 is slightly below the Medicare amount, suggesting a competitive baseline for direct payers. However, commercial insurance negotiated rates vary widely, with some plans paying as little as $60 and others up to $480, reflecting the complex dynamics of payer contracts and network tiers. Because commercial rates can sometimes exceed the cash price due to administrative costs and contract structures, patients should verify their specific plan's allowed amount before assuming that using insurance will result in a lower out-of-pocket cost. To avoid unexpected charges, consumers should request an itemized bill if they choose to use insurance, as this allows for a thorough review of all services rendered and helps identify any potential errors or unbundled codes that could be disputed.