CT scan, pelvis
Facility: Stormont Vail Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $96
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.90x 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 |
|---|---|---|
| Ambetter / Centene | $61 - $93 | 57% |
| UnitedHealthcare | $61 - $93 | 57% |
| Blue Cross Blue Shield | $62 - $613 | 58% |
| Aetna | $96 - $98 | 90% |
| Humana | $96 - $98 | 90% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Stormont Vail Hospital in Topeka, KS, the facility's negotiated rates for in-network payers like Ambetter, UnitedHealthcare, and Blue Cross Blue Shield range from $61 to $98, with a median paid amount of $98.00. This negotiated rate is significantly higher than the Medicare benchmark of $106.81, which serves as the federal baseline for the true cost of care, and exceeds the median negotiated rate of $96.00 reported for the region. While commercial insurance contracts often result in higher out-of-pocket costs due to administrative overhead and contract dynamics, patients with high-deductible plans may find that paying the cash price directly is more economical, as the cash median is not listed but could theoretically be lower than the $98.00 insurance allowed amount.
To minimize unexpected costs, patients should proactively request a "self-pay" or "prompt-pay" discount before scheduling, as hospitals often offer immediate fee reductions for upfront payments that bypass costly insurance billing cycles. It is also critical to avoid accepting summary bills, which obscure individual charges, and instead demand a full itemized audit to identify errors, unbundled codes, or services not rendered, since over 80% of hospital bills contain inaccuracies. If a patient receives a balance bill for out-of-network ancillary services despite receiving care at an in-network facility, they should not pay immediately out of fear; instead, they should dispute the charge with their insurer to invoke federal protections under the No Surprises Act, ensuring they are not liable for the difference between the provider's full chargemaster rate and the allowed amount.