CT scan, pelvis
Facility: Osborne County Memorial Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $933
- Cash Discount Price: $876
- vs. Medicare Baseline: 8.74x 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 874% of the Medicare baseline (a markup of 774%). 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 |
|---|---|---|
| UnitedHealthcare | $784 | 734% |
| Health Partners Of Kansas | $887 | 830% |
| Wppa | $979 | 917% |
| Blue Cross Blue Shield | $1,010 | 946% |
Consumer Guidance & Cost Commentary
For the CT scan of the pelvis at Osborne County Memorial Hospital, the facility's cash price of $876.00 is notably lower than the gross charge of $1,031.00, offering a potential savings for patients with high-deductible plans who may not utilize insurance. While the facility is a Critical Access Hospital in Osborne, Kansas, with government-local ownership, the negotiated rates for commercial payers range from $784 to $1,010, which are generally higher than the cash price due to administrative costs and contract structures. It is important to note that the Medicare benchmark for this service is $106.81; commercial rates often exceed this baseline by significant margins, so comparing the facility's negotiated rates to the Medicare amount rather than the hospital's gross list price provides a clearer picture of actual value.
Patients should be aware that while in-network insurance contracts set a ceiling on what insurers will pay, the final amount you owe depends on your specific deductible status and plan details. If your insurance has not yet met your deductible, you may be responsible for the full negotiated rate, which could be higher than the cash price. To minimize costs, it is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce bills by 20% to 50% if paid upfront. Additionally, since over 80% of hospital bills contain errors, requesting a detailed, itemized statement before payment allows you to verify that all charges are accurate and to dispute any unbundled codes or services not rendered.