CT scan, pelvis
Facility: Mercy Hospital Columbus
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $1,765
- Cash Discount Price: $1,580
- vs. Medicare Baseline: 16.52x 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 1652% of the Medicare baseline (a markup of 1552%). 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 |
|---|---|---|
| Centivo Contracted [320505] | $25 | 23% |
| Humana | $71 - $2,309 | 66% |
| Medicaid / KanCare | $71 - $1,765 | 66% |
| UnitedHealthcare | $91 - $2,018 | 85% |
| Blue Cross Blue Shield | $91 - $1,765 | 85% |
| Medicare (plans) | $100 - $1,835 | 94% |
| Health Systems Inc Contracted [320174] | $1,045 | 978% |
| Insurance System Inc Contracted [320465] | $1,045 | 978% |
| Administrative Payor Contracted [320005] | $1,094 | 1024% |
| Cross Timbers Hospice [20098] | $1,765 | 1652% |
| Indian Health Service Contracted [320198] | $1,765 | 1652% |
| Pace Of The Ozarks Contracted [320518] | $1,765 | 1652% |
| Novasys Contracted [320285] | $1,765 | 1652% |
| Globalhealth Contracted [320145] | $1,765 | 1652% |
| Medical Associates Health Contracted [320444] | $1,765 | 1652% |
| Cherokee Nation Health Serv Contracted [320066] | $1,765 | 1652% |
| Elara Caring Aspire Hospice [20433] | $1,765 | 1652% |
| Centurion Of Missouri [20459] | $1,765 | 1652% |
| Halo Hcr Inc Hospice Contracted [320432] | $1,765 | 1652% |
| Mercy Mgd Behavioral Health Contracted [320259] | $1,765 | 1652% |
| Dept Of Veteran Affairs Contracted [320106] | $1,765 | 1652% |
| Kindful Hospice Contracted [320434] | $1,765 | 1652% |
| Aetna | $1,765 - $2,188 | 1652% |
| Home State Health Plan Contracted [320187] | $1,765 | 1652% |
| Mercy Hospice Okc [20252] | $1,765 | 1652% |
| Kindful Hospice [20434] | $1,765 | 1652% |
| Provider Partners Health Plans Contracted [320450] | $1,765 | 1652% |
| Qual Choice Contracted [320325] | $1,765 | 1652% |
| Ambetter / Centene | $1,765 | 1652% |
| Cigna | $1,765 | 1652% |
| Halo Hcr Inc Hospice [20432] | $1,765 | 1652% |
| Tricare | $1,771 | 1658% |
| Healthscope Contracted [320182] | $1,874 | 1755% |
| Workers Comp [20426] | $1,945 - $2,066 | 1821% |
| United Medical Resources Contracted [320454] | $2,018 - $2,309 | 1889% |
| Medica Contracted [320239] | $2,178 | 2039% |
| Preferred Health Plan Contracted [320522] | $2,188 | 2048% |
| Usa Managed Care Org Contracted [320429] | $2,188 | 2048% |
| Healthlink Contracted [320179] | $2,188 - $2,309 | 2048% |
| Mercy Benefit Admin Contracted [320251] | $2,188 - $2,309 | 2048% |
| First Health Contracted [320128] | $2,188 | 2048% |
| American Healthcare Alliance Contracted [320020] | $2,188 | 2048% |
| Federal Medical Center Contracted [320127] | $2,188 | 2048% |
| Point C Contracted [320238] | $2,309 | 2162% |
| Aither Health Contracted [320449] | $2,309 | 2162% |
| 90 Degree Benefits Contracted [320436] | $2,309 | 2162% |
| Edison Health Solutions Contracted [320502] | $2,309 | 2162% |
| Yuzu Health Contracted [320521] | $2,309 | 2162% |
| Auxiant Contracted [320462] | $2,309 | 2162% |
| Ebms Contracted [320493] | $2,309 | 2162% |
| Ppo Plus Contracted [320310] | $2,309 | 2162% |
| Benefit Management Contracted [320052] | $2,309 | 2162% |
| Reflect Health Contracted [320492] | $2,309 | 2162% |
| Show-Me Health Administrators Contracted [320483] | $2,309 | 2162% |
| Imagine 360 Contracted [320494] | $2,309 | 2162% |
| Private Health Care Systems Contracted [320320] | $2,309 | 2162% |
Consumer Guidance & Cost Commentary
For the CT scan of the pelvis at Mercy Hospital Columbus, the facility's cash price of $1,580 is lower than the median negotiated rate of $1,765 paid by most insurance plans. This price difference highlights a common billing dynamic where commercial insurance contracts often result in higher out-of-pocket costs for patients compared to self-pay options, particularly for those with high-deductible plans. While the facility's cash rate is also below the gross charge of $2,431, patients should verify if their specific insurance plan has a lower allowed amount than the facility's cash price, as paying cash might not always be the most economical choice depending on their deductible status.
The facility's negotiated rates for this procedure range from $25 to $2,309 across 56 different payers, with the majority of plans settling at $1,765. Notably, the facility's cash price of $1,580 is significantly lower than the Medicare benchmark of $106.81 when adjusted for the facility's critical access status and location, though the provided "vs_medicare" metric of 16.5% suggests a specific comparative context for this service line. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it does not eliminate the potential for higher costs if a patient chooses not to use their insurance or if ancillary services are billed separately. To minimize costs, individuals should request a prompt-pay discount before scheduling, which can reduce the final bill by 20% to 50%, and always demand an itemized bill to ensure no errors or unbundled charges