CT scan, pelvis
Facility: Amberwell Atchison Association
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $591
- Cash Discount Price: $1,156
- vs. Medicare Baseline: 5.53x 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 553% of the Medicare baseline (a markup of 453%). 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 |
|---|---|---|
| Triwest - All Plans | $381 | 357% |
| UnitedHealthcare | $381 - $2,074 | 357% |
| Humana | $381 - $581 | 357% |
| Superior Select Mcr Adv - All Plans | $381 | 357% |
| Va Ccn - All Plans | $381 | 357% |
| Blue Cross Blue Shield | $456 - $480 | 427% |
| Ambetter / Centene | $591 | 553% |
| Aetna | $636 | 595% |
| Cigna | $636 | 595% |
| Centrus Health Direct - All Plans | $867 | 812% |
| Oscar - All Plans | $867 | 812% |
| Multiplan - All Plans | $902 | 844% |
| Wppa Providrs Care - All Plans | $1,040 | 974% |
Consumer Guidance & Cost Commentary
For this CT scan of the pelvis at Amberwell Atchison Association, the cash price is $1,156, which matches the facility's median paid amount. While commercial insurance plans like UnitedHealthcare and Humana negotiate rates ranging from $381 to $2,074, these negotiated amounts are often higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, especially since the negotiated rates for many payers exceed the cash rate. To secure the lowest possible price, patients should explicitly ask the facility about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower the final bill.
This facility is a Critical Access Hospital in Atchison, Kansas, and its pricing is benchmarked against Medicare, which sets the baseline for fair cost. The Medicare amount for this procedure is $106.81, meaning the cash price represents a significant markup compared to the federal government's cost-based rate. While the data does not provide specific state or county average comparisons for this exact code, it is important to understand that commercial rates often include administrative overhead that can inflate the price well above the true cost of care. If you receive a bill that seems unexpectedly high, you have the right to request an itemized audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain discrepancies that can be corrected.