CT scan, pelvis
Facility: Fredonia Regional Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $636
- Cash Discount Price: $706
- vs. Medicare Baseline: 5.95x 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 595% of the Medicare baseline (a markup of 495%). 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 | $349 - $480 | 327% |
| UnitedHealthcare | $360 - $636 | 337% |
| Veterans Programs - All Plans | $360 | 337% |
| Aetna | $360 - $636 | 337% |
| Reserve National-All Plans | $636 | 595% |
| Meritain-All Plans | $636 | 595% |
| Cigna | $636 | 595% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Fredonia Regional Hospital in Kansas, the cash price is $706.00, which matches the facility's median negotiated rate of $636.00 and the median amount paid by insurers. While the gross charge is $706.00, the Medicare benchmark for this service is significantly lower at $106.81, indicating that the facility's rates are well above the federal cost baseline. Patients with high-deductible plans may find the cash price of $706.00 more affordable than their insurance negotiated rate of $636.00 if their out-of-pocket costs exceed the difference, though in this specific case, the cash price is identical to the negotiated amount. It is important to note that while the facility is a Critical Access Hospital in a rural area, patients should still verify their specific plan details, as some commercial payers like UnitedHealthcare and Aetna have negotiated ranges extending up to $636.00, whereas Veterans Programs have a fixed rate of $360.00.
To ensure you are not overcharged, you should request an itemized billing audit before paying any balance bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you receive a surprise bill for out-of-network ancillary services, the No Surprises Act may protect you from paying the difference between the provider's chargemaster and your insurance allowed amount. Additionally, since hospitals often offer prompt-pay discounts of 20% to 50% for upfront payment, you should ask the billing department about self-pay or prompt-pay rates before