CT scan, pelvis
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $96
- Cash Discount Price: $1,041
- 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 |
|---|---|---|
| Humana | $94 | 88% |
| Aetna | $96 - $120 | 90% |
| Blue Cross Blue Shield | $96 - $462 | 90% |
| Providrs Care Network | $96 | 90% |
| United Mine Workers Of America | $96 | 90% |
| UnitedHealthcare | $96 - $116 | 90% |
| Lantern Specialty Care | $153 | 143% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Kansas Spine & Specialty Hospital in Wichita, KS, the cash median price is $1,041, which is lower than the facility's gross charge of $1,602. While commercial insurance plans like Aetna and UnitedHealthcare negotiate rates ranging from $94 to $462, these negotiated amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying cash directly. To ensure you receive the best possible rate, it is essential to ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce the final bill.
When evaluating this price, it is important to compare it against the Medicare benchmark rather than the hospital's inflated list price. The Medicare amount for this procedure is $106.81, and the facility's negotiated rate of $96 represents a fair pricing structure relative to this federal baseline, avoiding the common pitfall of comparing discounts to the gross chargemaster. Additionally, if you are concerned about billing errors, request a full itemized statement before paying, as summary bills often hide unbundled codes or services not rendered. Always verify your deductible status and confirm whether the facility is truly in-network to avoid unexpected balance billing, especially given that federal protections now ban surprise bills for out-of-network services at in-network facilities.