CT scan, pelvis
Facility: Morris County Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $757
- Cash Discount Price: $1,164
- vs. Medicare Baseline: 7.09x 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 709% of the Medicare baseline (a markup of 609%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $147 | 138% |
| Blue Cross Blue Shield | $456 - $757 | 427% |
| UnitedHealthcare | $757 - $1,940 | 709% |
| Va Ccn-All Plans | $757 | 709% |
| Coventry Mcr | $757 | 709% |
| Choice Care Mcr Adv-All Plans | $757 | 709% |
| Cigna | $1,403 | 1314% |
| Aetna | $1,738 | 1627% |
| Coventry Comm-All Other Plans | $1,746 | 1635% |
| Multiplan-All Plans | $1,746 | 1635% |
Consumer Guidance & Cost Commentary
For CPT code 72192 (CT scan, pelvis) at Morris County Hospital in Council Grove, KS, the facility's cash price of $1,164 is significantly lower than the negotiated rates charged by major insurers like UnitedHealthcare ($757–$1,940) and Aetna ($1,738). While the facility is a Critical Access Hospital with government local ownership, the cash rate remains higher than the state average for this procedure, which is reflected in the median paid amount of $1,080. Because the cash price is lower than the negotiated rates for many payers, patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, provided they can secure a self-pay or prompt-pay discount from the hospital before scheduling.
It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details to avoid unexpected costs. If you choose to use insurance, be aware that the facility's gross charge of $1,940 is the maximum list price, but commercial payers negotiate lower caps, such as the $1,470 cap for Providrs Care. To ensure you are receiving the best possible rate, we recommend requesting an itemized billing audit to confirm all charges are accurate and asking the billing department about any prompt-pay discounts available for upfront payment, which can reduce the total cost by 20% to 50%.