CT scan, pelvis
Facility: Memorial Hospital
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $1,486
- Cash Discount Price: $2,703
- vs. Medicare Baseline: 13.91x 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 1391% of the Medicare baseline (a markup of 1291%). 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 | $484 | 453% |
| Tricare | $1,351 | 1265% |
| Humana | $1,351 | 1265% |
| Medicare (plans) | $1,365 | 1278% |
| Ambetter / Centene | $1,486 | 1391% |
| Coventry - All Other Plans | $2,432 | 2277% |
| Health Partners Of Kansas - All Plans | $2,567 | 2403% |
| Preferred Healthcare-All Plans | $2,567 | 2403% |
| Wppa/Providers Care-All Plans | $3,784 | 3543% |
Consumer Guidance & Cost Commentary
For a CT scan of the pelvis at Memorial Hospital in Abilene, KS, the cash price is $2,703, which matches the facility's median negotiated rate of $1,486. While the hospital is a Critical Access Hospital with a government ownership structure, the cash price is notably higher than the median negotiated rate, suggesting that paying out-of-pocket may not be the most cost-effective option for those with high-deductible plans. In this specific case, the cash price exceeds the negotiated amount, meaning patients with active insurance coverage would likely pay less than the full cash price. However, patients should always verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts, as these incentives can reduce the final amount owed before insurance processing begins.
The facility's pricing is benchmarked against Medicare, which sets a fixed reimbursement rate of $106.81 for this procedure. The data indicates a 13.9% variance between the facility's rates and the Medicare benchmark, highlighting that commercial rates often exceed the federal baseline due to administrative costs and contract dynamics. It is important to note that comparing discounts to the hospital's gross charge list can be misleading; the true measure of value is how the negotiated rate compares to the Medicare rate. Since over 80% of hospital bills contain errors, patients should request a detailed, itemized bill to ensure no unbundled codes or services not rendered are included, rather than accepting a summary invoice that obscures the actual cost components.