CT scan, pelvis
Facility: Kiowa County Memorial Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $712
- Cash Discount Price: $680
- vs. Medicare Baseline: 6.67x 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 667% of the Medicare baseline (a markup of 567%). 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 - $712 | 429% |
| UnitedHealthcare | $641 - $800 | 600% |
| Health Partners Of Ks-All Plans | $704 | 659% |
| Celtic Comml Exchange-All Other Plans | $712 | 667% |
| Humana | $712 | 667% |
| Aetna | $712 | 667% |
| Medica Prime Mcare Cost-All Plans | $712 | 667% |
| Medicaid / KanCare | $800 | 749% |
| Providrs Care/Wppa-All Plans | $1,200 | 1123% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Kiowa County Memorial Hospital, the facility's cash median rate of $680.00 is lower than the negotiated rates paid by most major insurers, which range from $704 to $800. This pricing structure highlights a common billing dynamic where paying out-of-pocket can be more cost-effective than using insurance, particularly for patients with high deductibles or those who have already met their out-of-pocket maximum. Since the facility is a Critical Access Hospital in Greensburg, KS, and operates under government-local ownership, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final bill by bypassing the administrative costs associated with insurance claims processing.
While the facility's negotiated rates are generally higher than the cash price, it is important to note that commercial insurance contracts often include administrative markups that can inflate the baseline price by 20% to 40% compared to direct patient payments. Although the data does not provide specific county or state average comparisons for this procedure, the Medicare benchmark rate of $106.81 serves as a critical baseline for evaluating the facility's pricing; commercial rates in this region typically average between 200% and 300% of the Medicare amount, whereas fair pricing is often defined as 120% to 150%. Patients should verify their specific plan's allowed amount before treatment and consider requesting an itemized billing audit if they receive a summary bill, as over 80% of hospital invoices contain errors such as unbundled codes or services not rendered that could be disputed to reduce the total owed.