CT scan, pelvis
Facility: Stafford County Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $766
- Cash Discount Price: $766
- vs. Medicare Baseline: 7.17x 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 717% of the Medicare baseline (a markup of 617%). 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 |
|---|---|---|
| Health Partners-All Plans | $728 | 682% |
| UnitedHealthcare | $766 | 717% |
| Medica Mcr- All Plans | $766 | 717% |
| Humana | $766 | 717% |
| Va Ccn-All Plans | $766 | 717% |
Consumer Guidance & Cost Commentary
For the CPT code 72192 (CT scan, pelvis) at Stafford County Hospital in Stafford, KS, the facility's cash and negotiated rates are consistently $766.00 across all five payers, including Health Partners, UnitedHealthcare, and Humana. This rate is significantly higher than the Medicare benchmark of $106.81, reflecting a markup typical of commercial contracts which often average 200% to 300% of the federal baseline. While the data does not provide specific county or state average comparisons for this exact procedure, patients should be aware that commercial rates frequently exceed the "true cost" established by Medicare, which serves as the only scientifically validated cost baseline in the United States.
Because the facility is a Critical Access Hospital with government ownership, patients may find that paying cash directly is the most cost-effective option, especially if their insurance deductible has not yet been met. The data shows a median paid amount of $766.00, which matches the cash price, suggesting that insurance negotiation did not lower the final cost for this specific service. To potentially reduce this amount, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can range from 20% to 50% off the listed price when bills are settled upfront. Additionally, since the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, patients can rest assured that they will not be billed for the difference between the hospital's chargemaster and their insurance allowed amount for this procedure.