CT scan, pelvis
Facility: Rooks County Health Center
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $1,288
- Cash Discount Price: $1,073
- vs. Medicare Baseline: 12.06x 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 1206% of the Medicare baseline (a markup of 1106%). 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 | $480 | 449% |
| Tricare | $673 | 630% |
| Veterans Admin - All Plans | $673 | 630% |
| Celtic Mcr Adv | $673 | 630% |
| Celtic Comm - All Other Plans | $740 | 693% |
| Aetna | $1,288 | 1206% |
| Preferred Benefits Admin | $1,288 | 1206% |
| UnitedHealthcare | $1,288 | 1206% |
| Preferred Hlthcare - All Other Plans | $1,359 | 1272% |
| Health Partners - All Plans | $1,359 | 1272% |
| Healthy Blue Mcaid - All Plans | $1,431 | 1340% |
Consumer Guidance & Cost Commentary
For this CT scan of the pelvis at Rooks County Health Center in Plainville, Kansas, the facility's negotiated rates for major payers like Aetna, UnitedHealthcare, and Preferred Benefits Admin are $1,288, which matches the median paid amount. This rate is 12.1% higher than the Medicare benchmark of $1,06.81, reflecting the standard markup for commercial insurance contracts that include administrative processing costs. While the facility is a Critical Access Hospital owned by a government district, the negotiated price for in-network members is significantly higher than the cash-pay median of $1,073. Patients with high-deductible plans or those who have already met their out-of-pocket limits may find paying the cash price directly more cost-effective, as the cash rate is lower than the insurance negotiated ceiling.
To minimize costs, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the bill by 20% to 50% by bypassing expensive claims processing. It is important to note that while the facility is in-network for these payers, the actual amount charged depends on your specific plan's deductible status; if you have not yet met your deductible, you will be responsible for the full negotiated rate of $1,288 rather than a lower allowed amount. Additionally, because this is a government-owned facility, balance billing is unlikely for in-network services, but patients should always request an itemized bill to ensure no unbundled codes or services not rendered are included before finalizing payment.