CT scan, pelvis
Facility: St Luke Hospital & Living Center
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $964
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 9.03x 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 903% of the Medicare baseline (a markup of 803%). 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 | $964 | 903% |
| UnitedHealthcare | $964 | 903% |
| Bluestem Pace | $964 | 903% |
| Va Ccn | $964 | 903% |
| Kansas Department Of Health And Environment | $964 | 903% |
| Humana | $964 | 903% |
| Ambetter / Centene | $974 | 912% |
Consumer Guidance & Cost Commentary
For the CT scan of the pelvis at St Luke Hospital & Living Center in Marion, KS, the negotiated rate is $964, which is significantly lower than the facility's gross charge of $1,890. This facility is a Critical Access Hospital owned by a government hospital district, and while the data does not provide specific cash or median paid amounts, patients should be aware that cash-pay options can sometimes be more affordable than insurance negotiated rates, particularly for those with high-deductible plans. Since the negotiated rate here is set at $964, it is important to verify if a self-pay or prompt-pay discount is available before scheduling, as paying upfront can often bypass administrative fees and reduce the final cost.
The Medicare benchmark for this service is $106.81, which serves as a baseline for evaluating the facility's pricing markup. The negotiated rate of $964 represents a substantial increase over the Medicare amount, reflecting the administrative structures and contract dynamics typical of commercial insurance. Patients should avoid comparing this rate to the gross charge, as the full list price is inflated to make discounts appear larger; instead, the most accurate comparison is against the Medicare rate. If you receive a bill that exceeds the negotiated amount, it may be due to balance billing from out-of-network ancillary services, and you have the right to dispute such charges under the No Surprises Act by requesting a formal audit from your insurer.