CT scan, pelvis
Facility: F W Huston Medical Center
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $1,097
- Cash Discount Price: $1,140
- vs. Medicare Baseline: 10.27x 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 1027% of the Medicare baseline (a markup of 927%). 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 | $458 | 429% |
| Aetna | $1,069 | 1001% |
| Humana | $1,126 | 1054% |
| Cigna | $1,211 | 1134% |
Consumer Guidance & Cost Commentary
For the CT scan of the pelvis at F W Huston Medical Center in Winchester, KS, the facility's cash median price of $1,140 is notably lower than the median negotiated rates charged by major insurers like Humana ($1,126) and Aetna ($1,069). While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance contracts often include administrative overheads that can inflate the final billed amount compared to direct cash payments. Although the cash price is slightly higher than the facility's own median negotiated rate of $1,097, it remains significantly below the gross charge of $1,425, illustrating how commercial contracts can sometimes exceed what a patient would pay out-of-pocket.
When evaluating this cost against the broader market, the Medicare benchmark for this service is $106.81, which serves as the objective baseline for fair pricing. The facility's cash rate represents a markup of approximately 10.3 times the Medicare amount, a figure that falls within the typical range where commercial rates average 200% to 300% of Medicare, though fair pricing is often defined as 120% to 150%. Given that the cash price is lower than the insurer negotiated rates, patients with high-deductible plans may find it financially advantageous to pay the cash price directly, potentially saving money on administrative fees and avoiding the impact of their deductible. Before scheduling, it is recommended to explicitly request a "self-pay" or "prompt-pay" discount classification to ensure the facility applies any available upfront payment incentives.