CT scan, pelvis
Facility: Lane County Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $950
- Cash Discount Price: $950
- vs. Medicare Baseline: 8.89x 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 889% of the Medicare baseline (a markup of 789%). 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 |
|---|---|---|
| UnitedHealthcare | $855 - $950 | 800% |
| Aetna | $855 - $902 | 800% |
| Medicaid / KanCare | $950 - $1,045 | 889% |
| Healthy Blue Mcr Adv - All Other Plans | $950 | 889% |
| Healthy Blue Mcaid | $950 | 889% |
| Wppa Providers-All Plans | $1,425 | 1334% |
Consumer Guidance & Cost Commentary
For this CT scan of the pelvis at Lane County Hospital in Dighton, Kansas, the cash price is $950, which matches the facility's negotiated rates with UnitedHealthcare, Aetna, and Healthy Blue plans. While the hospital is a Critical Access Hospital owned by a Government Hospital District, the cash rate is notably higher than the Medicare benchmark of $106.81, reflecting the standard administrative markup inherent in commercial billing. Because the cash price aligns with the negotiated rates for most major payers, patients with high-deductible plans may find paying out-of-pocket upfront to be the most cost-effective option, avoiding potential deductibles or co-pays that could exceed the $950 amount.
It is important to note that while the No Surprises Act protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, patients should still verify their specific plan details before scheduling. If you have insurance, the facility will submit a claim to your carrier, and you will be responsible for any applicable deductible, coinsurance, or copayment up to the allowed amount, which appears to be $950 for this service. To ensure you receive the lowest possible rate, we strongly recommend asking the billing department about "self-pay" or "prompt-pay" discounts before your visit, as paying in full upfront can sometimes bypass insurance processing fees and administrative overhead.