CT scan, pelvis
Facility: Phillips County Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $572
- Cash Discount Price: $537
- vs. Medicare Baseline: 5.36x 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 536% of the Medicare baseline (a markup of 436%). 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 | $480 - $512 | 449% |
| UnitedHealthcare | $506 - $632 | 474% |
| Medicaid / KanCare | $632 | 592% |
| Health Partners-All Plans | $632 | 592% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Phillips County Hospital in Phillipsburg, Kansas, the facility's cash price of $537.00 is notably lower than the average negotiated rates paid by commercial insurers, which range from $480 to $632 depending on the plan. While Medicaid and Health Partners-All Plans pay the full gross amount of $632.00, commercial payers like Blue Cross Blue Shield and UnitedHealthcare negotiate rates that fall between $480 and $512.00. This data highlights a common pricing dynamic where cash payments can sometimes be more cost-effective for patients with high-deductible plans, as the cash price avoids the administrative markup often embedded in insurance contracts. However, patients should verify their specific plan's allowed amount before scheduling, as in-network rates vary significantly even within the same facility.
When evaluating the cost relative to federal standards, the facility's cash price of $537.00 is approximately 5.4% higher than the Medicare benchmark of $106.81, reflecting the typical markup seen in commercial healthcare pricing. It is important to note that while the facility is a Critical Access Hospital owned by the local government, patients should proactively request a "self-pay" or "prompt-pay" discount prior to check-in to potentially lower the final bill further. Additionally, if you are concerned about billing accuracy, you should request a detailed, itemized statement rather than accepting a summary bill, as over 80% of hospital invoices contain errors such as double-billing or unbundled codes that can be corrected through a formal written audit.