CT scan, pelvis
Facility: Ellinwood District Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $413
- Cash Discount Price: $502
- vs. Medicare Baseline: 3.87x 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 387% of the Medicare baseline (a markup of 287%). 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 | $413 | 387% |
| Humana | $413 | 387% |
| Cigna | $413 | 387% |
| Aetna | $413 | 387% |
| UnitedHealthcare | $413 | 387% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Ellinwood District Hospital, the negotiated rate for in-network insurance is $413.00, which matches the lowest and highest prices reported across all five major payers including Blue Cross Blue Shield, Humana, Cigna, Aetna, and UnitedHealthcare. This negotiated amount is significantly higher than the facility's cash price of $502.00, meaning patients with high-deductible plans or those paying out-of-pocket might find the cash rate more affordable if they qualify for a self-pay or prompt-pay discount. While the facility is a Critical Access Hospital in Ellinwood, KS, the data does not provide specific county or state average comparisons to contextualize this price relative to regional norms.
The Medicare benchmark for this service is $106.81, which serves as the objective baseline for evaluating the facility's pricing markup. The negotiated rate of $413.00 represents a 3.9x increase over the Medicare amount, illustrating the typical administrative and contractual layers that inflate commercial rates above the true cost of care. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it is essential to verify the exact status of the procedure and any ancillary services before scheduling to avoid unexpected charges.