CT scan, pelvis
Facility: St. Catherine Hospital - Garden City
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $383
- Cash Discount Price: $1,456
- vs. Medicare Baseline: 3.59x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 359% of the Medicare baseline (a markup of 259%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Kaiser | $72 - $1,345 | 67% |
| Cigna | $72 - $310 | 67% |
| Medicare (plans) | $72 - $84 | 67% |
| UnitedHealthcare | $72 - $1,482 | 67% |
| Kansas Health | $72 | 67% |
| Aetna | $72 - $2,015 | 67% |
| Blue Cross Blue Shield | $72 - $569 | 67% |
| Humana | $72 - $84 | 67% |
| Devoted Health | $84 | 79% |
| Innovage | $84 | 79% |
| United Colorado Doctor'S Plan | $245 | 229% |
| Direct To Employer | $322 - $1,953 | 301% |
| Centura Employee Plan | $337 | 316% |
| Peak Health | $433 - $1,905 | 405% |
| Multiplan | $592 - $4,151 | 554% |
| Denver Health | $1,153 | 1079% |
| Wpaa | $1,676 | 1569% |
| Christian Health Aid | $1,916 | 1794% |
| Health Partners Of Kansas | $2,323 | 2175% |
Consumer Guidance & Cost Commentary
For the CT scan of the pelvis (CPT 72192) at St. Catherine Hospital in Garden City, Kansas, the facility's cash median price is $1,456, while the average amount paid by insurance plans is $180. This significant difference highlights that cash-paying can sometimes be more cost-effective for patients with high-deductible plans, as the negotiated rates from major payers like Multiplan and Aetna can exceed the cash price. The facility's cash rate is notably lower than the gross chargemaster of $3,639, but it remains substantially higher than the Medicare benchmark of $106.81, which serves as the federal baseline for true cost. When comparing to regional standards, the facility's cash rate is higher than the state average for this procedure, though specific county averages were not provided in the data.
Patients should be aware that while many payers like Kaiser and Cigna have negotiated rates as low as $72, these figures often represent internal system rates or specific plan caps that may not apply to all members. The No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, but it is crucial to request a full itemized bill before paying to ensure no unbundled codes or services not rendered are included. Additionally, patients should ask about prompt-pay discounts, which can reduce the final cash bill by 20% to 50% if paid upfront, bypassing the administrative costs associated with insurance claims processing. Always verify your specific plan's allowed amount and deductible status before scheduling to avoid unexpected out-of-pocket expenses.