CT scan, pelvis
Facility: Stanton County Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $1,747
- Cash Discount Price: $1,838
- vs. Medicare Baseline: 16.36x 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 1636% of the Medicare baseline (a markup of 1536%). 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 | $456 - $1,747 | 427% |
| Healthy Blue Mcr Adv - All Other Plans | $1,801 | 1686% |
| Healthy Blue Mcaid | $1,838 | 1721% |
Consumer Guidance & Cost Commentary
For the CT scan of the pelvis at Stanton County Hospital in Johnson, KS, the cash price is $1,838, which matches the facility's negotiated rate for Healthy Blue Mcaid and the high-end of the range for Blue Cross Blue Shield. While the median amount paid by insurers was $1,774, the cash price remains the highest figure in this dataset, meaning paying out-of-pocket is not the most economical option for those with active insurance coverage. It is important to note that cash-pay can sometimes be cheaper for patients with high-deductible plans if their insurance negotiated rate exceeds the cash price, but in this specific case, the cash rate is already at the maximum negotiated level, so no additional savings are available through self-pay discounts at this facility.
This procedure's pricing is significantly higher than the Medicare benchmark of $106.81, reflecting a markup of 16.4% above the Medicare rate, which aligns with the typical commercial pricing structure where rates often range between 200% and 300% of Medicare. Although the facility is a Critical Access Hospital owned by the local government, the lack of a specific county or state average in the provided data prevents a direct comparison to regional norms. Patients should verify their specific plan's deductible status before scheduling, as the $1,774 median paid amount may not be covered if the deductible has not yet been met. Additionally, while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, patients should always request an itemized bill to ensure no unbundled codes or services not rendered are included in the final charge.