CT scan, pelvis
Facility: Kiowa District Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $816
- Cash Discount Price: $691
- vs. Medicare Baseline: 7.64x 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 764% of the Medicare baseline (a markup of 664%). 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 |
|---|---|---|
| Healthchoice-All Plans | $280 | 262% |
| Tricare | $337 | 316% |
| Blue Cross Blue Shield | $453 | 424% |
| UnitedHealthcare | $691 - $864 | 647% |
| Health Partners Of Ks-All Plans | $760 | 712% |
| Humana | $780 | 730% |
| Gbs Insurance - All Plans | $812 | 760% |
| Multiplan-All Plans | $812 | 760% |
| Triwest-All Plans | $821 | 769% |
| Aetna | $821 | 769% |
| Medicare (plans) | $821 | 769% |
| Medicaid / KanCare | $864 | 809% |
| Providers Care (Wppa)-All Plans | $1,296 | 1213% |
| Liberty Healthshare-All Plans | $1,395 | 1306% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Kiowa District Hospital, the cash price is $691.00, which is lower than the facility's negotiated rates for most major payers. While the median negotiated amount across 14 payers is $812.00, the cash rate offers a potential savings of $121.00 compared to the average insurance payment. This price difference is particularly relevant for patients with high-deductible plans, as paying the cash price upfront can be more cost-effective than incurring the higher negotiated fees that insurance companies charge. Additionally, patients should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing administrative processing costs associated with insurance claims.
The facility's pricing is evaluated against the Medicare benchmark of $106.81, which serves as a scientifically validated baseline for the true cost of care. Although the commercial negotiated rates average significantly higher than Medicare, the cash price of $691.00 remains a critical reference point for consumers. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still request an itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included. By comparing the cash rate to the Medicare benchmark and actively seeking prompt-pay discounts, patients can ensure they are paying a fair and transparent price for their care.