CMS Price Transparency Data

CT scan, pelvis

Facility: Lmh

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $105
  • Cash Discount Price: $697
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Lmh is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $697. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.98x the Medicare baseline. Located in 325 Maine Street, Lawrence, KS.
Cash / Self-Pay
$697

Average discount available for prompt cash payment at this facility.

Insurance Median
$105

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: $697 (653%)
Insurance Median: $105 (98%)
Cash: $697 (653% of Medicare)
Ins. Median: $105 (98% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

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

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Cigna $39 - $1,862 37%
UnitedHealthcare $39 - $1,851 37%
Medicare (plans) $39 - $105 37%
Humana $39 - $105 37%
Blue Cross Blue Shield $46 - $1,804 43%
Haskell Indian Health Services $46 - $105 43%
Ambetter / Centene $47 - $163 44%
Allwell $47 - $107 44%
Aetna $1,835 - $2,314 1718%
Non Contracted $2,230 2088%
First Health $2,593 2428%

Consumer Guidance & Cost Commentary

Lmh, an acute care hospital located at 325 Maine Street in Lawrence, Kansas, has a cash median rate of $697 for a CT scan of the pelvis. This facility is owned by the local government and holds a rating of 4 stars. While specific state or county average data is not provided in this report, the facility's cash rate is notable for being significantly lower than the highest negotiated rates seen among commercial payers, such as First Health and Blue Cross Blue Shield, which range from $2,230 to $2,593. For patients with high-deductible plans, paying the $697 cash price directly may result in substantial savings compared to the potentially much higher amounts their insurance would negotiate with the facility.

The Medicare benchmark for this service is $106.81, which serves as the objective baseline for evaluating pricing markups. The facility's cash rate of $697 is approximately 6.5 times the Medicare amount, whereas the median negotiated rate for commercial payers is $105, which is roughly 1.0 times the Medicare rate. This disparity highlights that while cash rates appear high relative to Medicare, they can still be far more affordable than the commercial negotiated rates charged to insured members. Patients are encouraged to verify if the facility offers self-pay or prompt-pay discounts, which can further reduce the final cost if the bill is paid in full upfront.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 325 Maine Street, Lawrence, KS 66044
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals