CT scan, pelvis
Facility: Stevens County Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $670
- Cash Discount Price: $770
- vs. Medicare Baseline: 6.27x 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 627% of the Medicare baseline (a markup of 527%). 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 |
|---|---|---|
| Humana | $285 | 267% |
| Aetna | $293 - $770 | 274% |
| Blue Cross Blue Shield | $456 - $480 | 427% |
| First Health - All Plans | $693 | 649% |
| Wppa - All Plans | $732 | 685% |
| Medicaid / KanCare | $770 | 721% |
Consumer Guidance & Cost Commentary
For the CPT code 72192 (CT scan, pelvis) at Stevens County Hospital in Hugoton, KS, the cash price is $770.00, which matches the facility's gross chargemaster rate. While commercial payers like Aetna and Blue Cross Blue Shield have negotiated rates ranging from $293 to $770, the cash price remains the highest single figure in this dataset. It is important to note that cash-pay can sometimes be more affordable for patients with high-deductible plans if their insurance negotiated rate exceeds the cash price, though in this specific case, the cash rate is equal to the maximum negotiated amount. Patients should always verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as these upfront fee reductions can significantly lower out-of-pocket costs compared to standard billing cycles.
This service is provided by a Critical Access Hospital in a rural setting, and the facility is owned by the local government. The Medicare benchmark for this procedure is $106.81, which serves as the objective baseline for evaluating pricing markups. Commercial negotiated rates for this service generally range from 200% to 300% of the Medicare amount, reflecting the administrative costs and contract dynamics inherent in insurance billing. Since the data does not include specific state or county average comparisons for this exact procedure, patients should rely on the Medicare rate as the standard for assessing whether the facility's pricing is reasonable. If you receive a bill that seems inconsistent with these benchmarks, you have the right to request an itemized billing audit to identify any errors, double-billing, or unbundled codes that may have inflated your total.