CT scan, pelvis
Facility: Great Plains Of Sabetha
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $630
- Cash Discount Price: $663
- vs. Medicare Baseline: 5.90x 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 590% of the Medicare baseline (a markup of 490%). 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 |
|---|---|---|
| Celtic Mcr Adv | $345 | 323% |
| Aetna | $348 - $670 | 326% |
| Celtic Comm Exchange-All Other Plans | $431 | 404% |
| Great West Healthcare-All Plans | $564 | 528% |
| UnitedHealthcare | $617 - $663 | 578% |
| Cigna | $630 | 590% |
| Multiplan-Phcs-All Plans | $630 | 590% |
| Humana | $630 | 590% |
| Century/Wppa/Providers-All Plans | $630 | 590% |
| Federated Mutual Ins-All Plans | $636 | 595% |
| Blue Cross Blue Shield | $663 | 621% |
| Medicaid / KanCare | $663 | 621% |
Consumer Guidance & Cost Commentary
For the CT scan of the pelvis at Great Plains Of Sabetha in Sabetha, Kansas, the cash price is $663.00, which matches the facility's gross charge and the cash median. This rate is significantly higher than the state average, reflecting the typical markup found in commercial pricing where negotiated rates often reach 200% to 300% of the Medicare benchmark. While the Medicare amount for this service is $106.81, the facility's cash price suggests a markup well above the fair pricing range of 120% to 150% of Medicare. Patients with high-deductible plans may find the cash price more affordable than their insurance negotiated rate, which averages $630.00 across various payers, though this negotiated amount still exceeds the Medicare baseline.
To minimize costs, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payment. Although the facility is a voluntary non-profit Critical Access Hospital, the lack of a published facility rating means independent consumer verification is essential. Given that balance billing protections under the No Surprises Act apply to emergency care and non-emergency services at in-network facilities, patients should ensure their plan is in-network to avoid unexpected out-of-pocket differences. Finally, requesting an itemized billing audit is recommended, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered, which can be disputed in writing to secure a fair final invoice.