CT scan, pelvis
Facility: Holton Community Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $1,816
- Cash Discount Price: $1,641
- vs. Medicare Baseline: 17.00x 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 1700% of the Medicare baseline (a markup of 1600%). 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 | $453 | 424% |
| UnitedHealthcare | $1,160 - $2,188 | 1086% |
| Aetna | $1,160 - $2,188 | 1086% |
| Humana | $1,171 | 1096% |
| Kansas Superior Select - All Plans | $1,183 | 1108% |
| Preferred Health Freedom | $1,816 | 1700% |
| Preferred Health Fn Select - All Other Plans | $1,816 | 1700% |
| Preferred Health Professionals | $1,816 | 1700% |
| Wppa Providers - All Plans | $2,079 | 1946% |
| Medicaid / KanCare | $2,188 | 2048% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Holton Community Hospital in Holton, KS, the cash price is $1,641, which is lower than the facility's gross charge of $2,188. While the hospital is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that insurance negotiated rates can sometimes exceed cash prices. For instance, UnitedHealthcare, Aetna, and Kansas Superior Select all have negotiated rates starting at $1,160 to $2,188, meaning a patient with a high-deductible plan might save money by paying the cash rate directly. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated amount could be required if you have not yet met your out-of-pocket threshold.
To ensure you are not overcharged, always request an itemized bill before paying, as summary bills often hide unbundled codes or services not rendered. If you receive a balance bill for out-of-network services at an in-network facility, you may be protected under the No Surprises Act, which bans balance billing for emergency and non-emergency care. Additionally, ask the billing department about prompt-pay discounts, which can reduce the cash price by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims processing.