CT scan, pelvis
Facility: Ashland Health Center
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $667
- Cash Discount Price: $534
- vs. Medicare Baseline: 6.24x 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 624% of the Medicare baseline (a markup of 524%). 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 | $223 | 209% |
| Compalliance-All Plans | $534 | 500% |
| Health Partners Of Kansas-All Plans | $567 | 531% |
| Multiplan-All Plans | $654 | 612% |
| UnitedHealthcare | $667 | 624% |
| Medicaid / KanCare | $667 | 624% |
| Medicare (plans) | $667 | 624% |
| Aetna | $667 | 624% |
| Medica Mcare - All Plans | $667 | 624% |
| Health Choice-All Plans | $667 | 624% |
| Healthy Blue Mcr Adv - All Other Plans | $667 | 624% |
| Providers Care (Wppa)-All Plans | $1,000 | 936% |
Consumer Guidance & Cost Commentary
For the CPT code 72192 (CT scan, pelvis) at Ashland Health Center in Ashland, KS, the facility's negotiated rates range from $223 to $1,000 depending on the insurance plan, with a median negotiated amount of $667. This figure aligns with the median paid amount of $667 and the median negotiated rate reported in the data. It is important to note that the cash median price for this service is $534, which is lower than the standard insurance negotiated rates. Patients with high-deductible plans or those without insurance may find it financially advantageous to pay the cash price of $534 directly, as this avoids the administrative markup and higher negotiated fees typically charged to commercial payers. To secure the lowest possible cost, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
The facility's pricing structure is evaluated against the Medicare benchmark, which serves as a scientifically validated baseline for healthcare costs. For this procedure, the Medicare amount is $106.81, and the facility's negotiated rates are significantly higher, reflecting the standard administrative and contractual dynamics of commercial insurance. While the data does not provide specific county or state average comparisons for this exact code, the facility operates as a Critical Access Hospital in a Voluntary non-profit setting, which often influences its pricing strategy. Consumers should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it is still prudent to request a full itemized bill before finalizing payment to ensure no unbundled codes or services not rendered are