CT scan, pelvis
Facility: Clara Barton Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $1,232
- Cash Discount Price: $958
- vs. Medicare Baseline: 11.53x 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 1153% of the Medicare baseline (a markup of 1053%). 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% |
| 6 Degrees Health - All Plans | $958 | 897% |
| Wppa-All Plans | $1,095 | 1025% |
| UnitedHealthcare | $1,232 | 1153% |
| Aetna | $1,232 | 1153% |
| Phcs - All Plans | $1,232 | 1153% |
| Hlth Partners Of Ks-All Plans | $1,259 | 1179% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Clara Barton Hospital in Hoisington, KS, the cash price is $958, which is lower than the facility's negotiated rate of $1,232. While the hospital is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance rates often exceed cash prices due to administrative overhead and contract dynamics. In this specific case, the cash rate is significantly lower than the median negotiated amount of $1,232, meaning patients with high-deductible plans or those without insurance could save money by paying directly. However, it is important to note that the cash price is also higher than the Medicare benchmark of $106.81, which serves as the federal baseline for evaluating hospital pricing markups.
When comparing this facility's pricing to broader market standards, the cash rate of $958 is notably lower than the median paid amount of $1,027 and the median negotiated rate of $1,232 across seven payers. The lowest negotiated rate among commercial payers is $453 for Blue Cross Blue Shield, which is substantially lower than the facility's cash price, suggesting that for some insured patients, using in-network coverage may result in lower out-of-pocket costs depending on their deductible status. Patients are encouraged to verify their specific plan details before scheduling, as assuming that in-network coverage equals the best price can lead to unexpected costs if the deductible has not been met. Additionally, patients should ask the hospital about self-pay or prompt-pay discounts before check-in, as paying in full upfront can sometimes bypass the higher administrative costs associated with insurance billing cycles.