CT scan, pelvis
Facility: Republic County Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $1,104
- Cash Discount Price: $900
- vs. Medicare Baseline: 10.34x 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 1034% of the Medicare baseline (a markup of 934%). 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 |
|---|---|---|
| Rural Carriers-All Plans | $1,020 | 955% |
| Aetna | $1,080 | 1011% |
| Meritain-All Plans | $1,080 | 1011% |
| UnitedHealthcare | $1,104 | 1034% |
| Cigna | $1,140 | 1067% |
| Midlands Choice-All Plans | $1,140 | 1067% |
| First Health-All Plans | $1,140 | 1067% |
Consumer Guidance & Cost Commentary
For this CT scan of the pelvis at Republic County Hospital in Belleville, KS, the negotiated rates paid by major insurers like Aetna, Cigna, and UnitedHealthcare average $1,104. This amount is slightly higher than the facility's cash median price of $900, which may offer a lower out-of-pocket cost for patients with high-deductible plans who have not yet met their coverage thresholds. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the negotiated rates reflect standard administrative costs and contract dynamics that often exceed cash prices. It is important to note that these commercial rates are significantly higher than the Medicare benchmark of $106.81, illustrating the typical markup found in commercial healthcare pricing.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services like lab work are billed separately. To ensure accuracy, consumers should request a full itemized bill before paying, as summary invoices often hide unbundled codes or services not rendered. Additionally, since hospitals frequently offer prompt-pay discounts for upfront cash payments, it is advisable to contact the billing department directly to inquire about self-pay rates or potential discounts before scheduling, ensuring you are not inadvertently subjecting yourself to higher insurance-driven charges.