CT scan, pelvis
Facility: Kansas Medical Center Llc
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $96
- Cash Discount Price: $642
- 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 |
|---|---|---|
| Medicaid / KanCare | $60 | 56% |
| Tricare | $87 | 81% |
| Indian Health | $87 | 81% |
| Medadv_Wellcare | $96 | 90% |
| Blue Cross Blue Shield | $96 - $437 | 90% |
| Humana | $96 | 90% |
| Ambetter / Centene | $96 | 90% |
| Three_Rivers | $193 | 181% |
| Aetna | $450 | 421% |
| Wppa | $525 | 492% |
| United | $580 | 543% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Kansas Medical Center Llc in Andover, the cash price is $642, which is lower than the facility's gross charge of $1,070. While the median amount paid by insurance plans is $870, patients with high-deductible plans may find paying cash upfront more cost-effective, as the cash rate is significantly lower than the typical negotiated rates of $96 to $580 seen across various payers. To maximize savings, patients should explicitly request a self-pay or prompt-pay discount before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees.
This facility's pricing structure is evaluated against federal benchmarks, where the Medicare rate for this procedure is $106.81. The cash price of $642 represents a markup relative to this baseline, illustrating how commercial rates often exceed the true cost of care. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still review their itemized bills for any unbundled codes or services not rendered. Always verify your specific plan's deductible status and allowed amounts before proceeding, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket costs than paying the cash price directly.