CT scan, pelvis
Facility: Providence Medical Center
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $133
- Cash Discount Price: $98
- vs. Medicare Baseline: 1.25x 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 - $202 | 85% |
| Celtic | $93 - $158 | 87% |
| Healthy Blue | $93 - $103 | 87% |
| Cigna | $98 | 92% |
| Tricare | $98 | 92% |
| Midland Care Connection | $98 | 92% |
| Medicare (plans) | $98 | 92% |
| Aetna | $98 - $315 | 92% |
| Kansas Superior Select | $103 | 96% |
| Corizon | $128 | 120% |
| Comp Alliance - Fka Compresults Worker Compensation | $134 | 125% |
| Employer Direct Healthcare | $138 | 129% |
| Well Path Prison | $138 | 129% |
| Oha Networks | $145 | 136% |
| Centurion | $148 | 139% |
| Worker Compensation | $149 | 140% |
| Naphcare | $153 | 143% |
| Blue Cross Blue Shield | $158 - $255 | 148% |
| First Health | $750 | 702% |
Consumer Guidance & Cost Commentary
For the CPT code 72192 (CT scan, pelvis) at Providence Medical Center in Kansas City, KS, the facility's cash price of $98.00 is significantly lower than the median negotiated rate of $133.00 and the gross charge of $1,719.00. While many commercial payers like UnitedHealthcare and Aetna have negotiated rates ranging from $91 to $315, the cash price remains the most affordable option for patients without insurance. This aligns with the principle that cash-pay can sometimes be cheaper for those with high-deductible plans, as the insurance negotiated rate often exceeds the cash price. Patients should explicitly ask the hospital for "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fees can bypass the administrative costs and higher negotiated rates associated with insurance billing.
The facility's cash rate of $98.00 is also notably lower than the Medicare benchmark of $106.81, suggesting a pricing structure that is competitive even against federal standards. However, patients must be aware of balance billing risks if they receive care from out-of-network providers or ancillary services like emergency physicians or labs, which can trigger unexpected bills for the difference between the provider's full charge and the insurance allowed amount. To avoid these surprises, consumers should request a full itemized CPT-coded bill before paying any invoice, as summary bills often obscure individual line items and errors. If a balance bill is received, patients should dispute it with their insurer and request a No Surprises Act audit rather than paying immediately, as federal protections often ban such billing for emergency and non-emergency services at in-network facilities