CT scan, pelvis
Facility: Pratt Regional Medical Center
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $176
- Cash Discount Price: $776
- vs. Medicare Baseline: 1.65x 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 |
|---|---|---|
| Celtic Insurance Company | $102 | 95% |
| Healthy Blue | $105 | 98% |
| UnitedHealthcare | $112 - $2,083 | 105% |
| Christian Health Aid | $132 - $1,532 | 124% |
| Health Partners Of Kansas | $150 - $1,736 | 140% |
| Aetna | $158 - $1,838 | 148% |
| Choicecare | $176 - $2,042 | 165% |
Consumer Guidance & Cost Commentary
For the CT scan of the pelvis at Pratt Regional Medical Center in Pratt, Kansas, the facility's cash median price of $776.00 is significantly lower than the negotiated rates paid by major insurers, which range from $102 to over $2,000 depending on the plan. While the facility's negotiated rates are higher than the cash price, patients with high-deductible plans may find it financially advantageous to pay the cash median directly, as the insurance negotiated amounts often exceed the out-of-pocket cost of paying upfront. To secure the lowest possible rate, patients should explicitly ask the billing department for "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing costly administrative processing fees.
This service's pricing is benchmarked against federal standards, where the Medicare amount of $106.81 serves as the objective baseline for evaluating the facility's markup. The facility's cash rate of $776.00 represents a 1.6x multiplier relative to the Medicare amount, which is consistent with the typical range of 120% to 150% considered fair for commercial pricing, though commercial contracts often push rates higher due to administrative overhead. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still request a detailed, itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.