CT scan, pelvis
Facility: Grisell Memorial Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $816
- Cash Discount Price: $889
- vs. Medicare Baseline: 7.64x 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 764% of the Medicare baseline (a markup of 664%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $430 | 403% |
| UnitedHealthcare | $696 - $936 | 652% |
| Medicaid / KanCare | $936 | 876% |
| Humana | $936 | 876% |
Consumer Guidance & Cost Commentary
For the CPT code 72192 (CT scan, pelvis) at Grisell Memorial Hospital in Ransom, Kansas, the facility's negotiated rates range from $430 to $936 depending on the insurance carrier. While the median negotiated amount paid is $936, the cash price is $889, meaning patients paying out-of-pocket could potentially save money if their insurance plan has a high deductible or if the negotiated rate exceeds the cash price. It is important to note that commercial insurance rates often include administrative costs and contract overhead, which can inflate the baseline price by 20% to 40% compared to direct cash payments. Additionally, the facility is a Critical Access Hospital with government ownership, which may influence its pricing structure compared to private entities.
When evaluating the cost of this service, it is essential to compare the facility's rates against the Medicare benchmark rather than the hospital's full chargemaster list. The Medicare amount for this procedure is $106.81, and the facility's cash price of $889 represents a significant markup above this federal baseline. While the data does not provide specific county or state average comparisons for this exact code, patients should be aware that assuming an in-network rate is the lowest possible price is a common pitfall, as different insurers negotiate different maximums. To ensure you receive the best possible rate, patients should request a self-pay or prompt-pay discount before scheduling, as hospitals often offer fee reductions of 20% to 50% for upfront payments that bypass costly claims processing.