CT scan, pelvis
Facility: Saint Luke'S South Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $1,009
- Cash Discount Price: $2,455
- vs. Medicare Baseline: 9.45x 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 945% of the Medicare baseline (a markup of 845%). 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 |
|---|---|---|
| Medicaid / KanCare | $60 - $136 | 56% |
| Humana | $89 - $145 | 83% |
| Aetna | $113 - $3,886 | 106% |
| UnitedHealthcare | $114 - $1,009 | 107% |
| Cigna | $118 - $3,105 | 110% |
| Transplants-Case Rates [5750] | $158 - $4,091 | 148% |
| Blue Cross Blue Shield | $226 - $3,072 | 212% |
| Commercial-Contracted [8000] | $959 - $3,310 | 898% |
| First Health [5512] | $2,425 | 2270% |
Consumer Guidance & Cost Commentary
For patients paying cash directly, the most important thing to know is that the cash median rate for this CT scan is $2,455. While this amount is lower than the facility's gross charge of $4,091, it is significantly higher than the median negotiated rate of $1,009 and the median paid rate of $266. Although cash payments can sometimes be cheaper for those with high-deductible plans if the insurance negotiated rate exceeds the cash price, the data shows that insurance contracts here cap costs much lower than the cash option. Patients should verify their specific plan's "allowed amount" before scheduling to ensure they are not paying more than the negotiated ceiling, and they should ask the hospital about "self-pay" or "prompt-pay" discounts that could further reduce the $2,455 cash rate.
The broader rate context reveals significant variation across payers and benchmarks. While the cash rate sits at $2,455, the gross charge of $4,091 represents the highest possible price before any discounts. Commercial insurers negotiate different rates, with some plans paying as low as $60 and others up to $4,091 depending on the contract tier. When compared to the Medicare benchmark, which is set at $106.81, the cash rate is 9.4 times higher, illustrating the substantial markup inherent in the facility's pricing structure. This comparison highlights that while the facility is a voluntary non-profit in Overland Park, KS, patients must carefully compare the facility's specific negotiated rates against their own plan's limits and the Medicare baseline to understand the true cost of care.