CT scan, pelvis
Facility: Hamilton County Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $1,305
- Cash Discount Price: $1,450
- vs. Medicare Baseline: 12.22x 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 1222% of the Medicare baseline (a markup of 1122%). 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 | $215 - $480 | 201% |
| First Health Coventry - All Plans | $1,232 | 1153% |
| Cigna | $1,378 | 1290% |
| UnitedHealthcare | $1,378 | 1290% |
| Va Ccn - All Plans | $1,450 | 1358% |
| Aetna | $2,465 | 2308% |
Consumer Guidance & Cost Commentary
For the CT scan of the pelvis (CPT code 72192) at Hamilton County Hospital in Syracuse, Kansas, the cash price is $1,450, which matches the facility's median negotiated rate. This cash price is significantly higher than the state average, representing a 12.2% markup over the Medicare benchmark of $106.81. While commercial insurance plans like Blue Cross Blue Shield and First Health Coventry offer negotiated rates ranging from $215 to $1,232, these amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying the cash price of $1,450 upfront may be more cost-effective than relying on insurance, as the insurer's allowed amount could be higher than the direct cash rate.
Patients should proactively contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% for upfront payment. It is important to verify the specific allowed amount for your plan before scheduling, as in-network rates vary widely among payers and do not guarantee the lowest possible cost. Additionally, if you choose to pay out-of-network, be aware that balance billing could result in charges for the difference between the provider's full rate and your insurance's allowed amount, though federal protections like the No Surprises Act may limit these charges for emergency care. To ensure accuracy, always request a detailed, itemized bill rather than a summary invoice, as over 80% of hospital bills contain errors that can be corrected through a formal audit.