CT scan, pelvis
Facility: Trego County Lemke Memorial Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $657
- Cash Discount Price: $659
- vs. Medicare Baseline: 6.15x 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 615% of the Medicare baseline (a markup of 515%). 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 |
|---|---|---|
| Humana | $380 | 356% |
| Tricare | $410 | 384% |
| Medicaid / KanCare | $480 - $775 | 449% |
| UnitedHealthcare | $480 - $775 | 449% |
| Va Ccn - All Plans | $480 | 449% |
| Aetna | $480 - $698 | 449% |
| Ambetter / Centene | $529 | 495% |
| Blue Cross Blue Shield | $657 | 615% |
| Health Partners - All Plans | $736 | 689% |
| Healthy Blue Mcaid - All Plans | $775 | 726% |
Consumer Guidance & Cost Commentary
For the CT scan of the pelvis at Trego County Lemke Memorial Hospital, the facility's cash price of $659 is notably higher than the state average of $481, though it aligns closely with the county average of $659. While the facility's cash rate exceeds the state median, patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the negotiated rates for many commercial payers range from $480 to $775, often exceeding the cash amount. It is important to note that the facility is a Critical Access Hospital owned by the local government, and while the cash price is competitive relative to the county, it remains above the state benchmark.
The facility's negotiated rates vary significantly by payer, with the lowest allowed amount being $380 for Humana and the highest at $775 for Health Partners. These negotiated rates generally exceed the Medicare amount of $106.81, reflecting the standard administrative markup inherent in insurance contracts. Patients should be aware that while the facility offers a cash price of $659, they should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the total cost by bypassing complex claims processing. Additionally, since the facility is in-network for most major payers, the No Surprises Act protects patients from unexpected balance billing for emergency services, ensuring that the final charge will not exceed the negotiated or cash rates listed above.