CT scan, pelvis
Facility: Decatur Health
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $852
- Cash Discount Price: $1,005
- vs. Medicare Baseline: 7.98x 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 798% of the Medicare baseline (a markup of 698%). 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 | $589 | 551% |
| Wppa/Providrs Care- All Plans | $670 | 627% |
| UnitedHealthcare | $681 - $852 | 638% |
| Humana | $688 | 644% |
| Midlands Choice- All Plans | $1,005 | 941% |
| Aetna | $1,005 - $1,116 | 941% |
| Medicaid / KanCare | $1,128 | 1056% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Decatur Health in Oberlin, Kansas, the cash price is $1,005, which is lower than the facility's negotiated rates for most major insurers like Aetna and UnitedHealthcare. While the facility's cash rate is higher than the state average for this procedure, it remains a competitive option for patients with high-deductible plans or those without insurance, as paying cash upfront can sometimes result in lower total costs than what insurance companies negotiate. Patients should verify if their specific plan has a lower negotiated rate before scheduling, as some commercial payers may offer better coverage than the cash price suggests.
To avoid unexpected charges, consumers should request a detailed, itemized bill rather than accepting a summary invoice, as hospitals often hide errors or unbundled charges within broad categories. Additionally, if you are self-pay, ask about prompt-pay discounts, which can reduce the bill by 20% to 50% if paid in full within 30 days, effectively bypassing administrative fees and claim processing costs. If you receive a balance bill from an out-of-network provider, you may be entitled to protections under the No Surprises Act, which prevents providers from charging you the difference between their full rate and your insurance allowed amount for emergency or non-emergency services at in-network facilities.