CT scan, pelvis
Facility: Clay County Medical Center
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $103
- Cash Discount Price: $1,013
- vs. Medicare Baseline: 0.96x 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.
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 |
|---|---|---|
| Multiplan- All Plans | $51 - $1,821 | 48% |
| UnitedHealthcare | $65 - $1,821 | 61% |
| Health Partners - All Plans | $75 - $1,821 | 70% |
| Wppa/Providrs Care- All Plans | $101 - $1,783 | 95% |
| Aetna | $101 - $1,783 | 95% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Clay County Medical Center in Clay Center, KS, the cash price is $1,013.00, which matches the facility's median paid amount. This cash rate is significantly lower than the negotiated rates charged by major insurers like UnitedHealthcare, Aetna, and Multiplan, where allowed amounts range from $65 to $1,821. While commercial insurance contracts often cap payments at these negotiated levels, patients with high-deductible plans may find paying the cash price directly more cost-effective if their insurance allowed amount exceeds $1,013.00. To secure the lowest possible price, patients should explicitly request "self-pay" or "prompt-pay" discounts from the hospital before scheduling, as these upfront payment incentives can bypass standard insurance billing cycles and administrative fees.
The facility's pricing is benchmarked against federal standards, with a Medicare rate of $106.81 for this procedure. The cash price of $1,013.00 represents a substantial markup compared to this federal baseline, which is typical for commercial pricing structures that include administrative overhead and profit margins. Because over 80% of hospital bills contain errors, patients should never accept a summary bill as final; instead, they should demand a full itemized statement showing specific CPT codes to identify any unbundled charges or services not rendered. If a patient receives a bill that exceeds the negotiated rate or Medicare benchmark, they should dispute it in writing with the billing supervisor rather than paying immediately, as the No Surprises Act provides protections against balance billing for out-of-network services at in-network facilities.