CT scan, pelvis
Facility: Community Memorial Healthcare, Inc.
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $714
- Cash Discount Price: $1,384
- vs. Medicare Baseline: 6.68x 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 668% of the Medicare baseline (a markup of 568%). 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 | 449% |
| Aetna | $637 - $1,038 | 596% |
| UnitedHealthcare | $792 | 742% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Community Memorial Healthcare in Marysville, Kansas, the cash price is $1,384, which matches the facility's median paid amount. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the negotiated rates vary significantly by insurer. Blue Cross Blue Shield pays a flat $480, whereas Aetna's range from $637 to $1,038 across two plans, and UnitedHealthcare pays a fixed $792. It is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract dynamics; in this case, paying cash directly could result in a lower out-of-pocket cost than using insurance if your plan has a high deductible or if the negotiated rate exceeds the cash price.
This service is priced at 6.7 times the Medicare benchmark of $106.81, which serves as the objective baseline for evaluating hospital pricing markups. Although the data provided does not include specific county or state average figures for comparison, the facility's location in the 66508 zip code suggests local cost variations that should be considered when evaluating value. To minimize costs, patients should verify if their specific insurance plan has met its deductible before scheduling, as paying the full negotiated rate without meeting this threshold can be financially burdensome. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before check-in, as these upfront payment incentives can bypass the costly insurance billing cycle and reduce the final bill.