CT scan, pelvis
Facility: Hospital District #6 Patterson Health Center
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $855
- Cash Discount Price: $760
- vs. Medicare Baseline: 8.00x 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 800% of the Medicare baseline (a markup of 700%). 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 | $430 - $453 | 403% |
| UnitedHealthcare | $855 - $950 | 800% |
| Providers Care (Wppa)-All Plans | $1,662 | 1556% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Hospital District #6 Patterson Health Center in Anthony, KS, the facility's cash median price is $760, which is lower than the negotiated rates paid by UnitedHealthcare at $855. While the facility is a Critical Access Hospital with government ownership, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the insurer's negotiated rate exceeds the cash amount. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details and ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not subject to unexpected charges.
The Medicare benchmark for this procedure is $106.81, which serves as a baseline for evaluating the facility's pricing structure; commercial rates are often significantly higher due to administrative costs and contract dynamics. Although the data does not provide specific state or county average comparisons for this code, the facility's cash rate of $760 remains a key figure for consumers to compare against their own insurance allowed amounts. To avoid billing errors, patients should request a full itemized bill that lists every CPT code and charge, as summary bills often obscure unbundled services or items not rendered. If a patient receives a bill that seems inconsistent with the cash or negotiated rates, they should dispute it in writing with the billing supervisor rather than accepting the summary invoice immediately.