CT scan, pelvis
Facility: Wilson Medical Center
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $701
- Cash Discount Price: $657
- vs. Medicare Baseline: 6.56x 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 656% of the Medicare baseline (a markup of 556%). 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 - $876 | 424% |
| UnitedHealthcare | $464 - $815 | 434% |
| Tricare | $464 | 434% |
| Ambetter / Centene | $464 - $876 | 434% |
| Humana | $464 | 434% |
| Aetna | $464 - $876 | 434% |
| Cigna | $701 | 656% |
| Health Partners-All Plans | $806 | 755% |
| Mulitplan-All Plans | $806 | 755% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Wilson Medical Center in Neodesha, KS, the facility's cash price of $657.00 is significantly higher than the state average of $511.00. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find paying cash directly cheaper than using insurance, as the negotiated rates for major payers like Blue Cross Blue Shield and Aetna range from $453 to $876. Because commercial contracts often include administrative overhead and multi-layered pricing structures, the cash price can sometimes represent a more transparent cost than the insurance negotiated ceiling.
To secure the lowest possible rate, patients should verify if the hospital offers a "prompt-pay" discount, which typically reduces the bill by 20% to 50% for upfront payment and bypasses costly insurance claims processing. It is crucial to request a self-pay classification before check-in to avoid automatic claims submission, which could void any cash discount and result in balance billing if the insurance allowed amount is lower than the cash price. Given that over 80% of hospital bills contain errors, patients should always request a full itemized CPT-coded statement rather than accepting a summary bill, ensuring they can accurately compare the facility's specific charges against the Medicare benchmark of $106.81 for this procedure.