CT scan, pelvis
Facility: Children'S Mercy South
Billing Code: 72192 (CPT)
- CPT Billing Code: 72192
- Insurance Median: $113
- Cash Discount Price: $816
- vs. Medicare Baseline: 1.06x 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 |
|---|---|---|
| UnitedHealthcare | $44 - $2,183 | 41% |
| Medicaid / KanCare | $48 - $70 | 45% |
| Healthy Blue | $48 - $273 | 45% |
| Home State Health | $50 - $240 | 47% |
| Cigna | $50 - $2,257 | 47% |
| Wppa Providrs Care | $66 - $2,111 | 62% |
| Healthlink | $66 - $2,858 | 62% |
| Health Midwest Comprehensive Care | $70 - $2,114 | 66% |
| American Healthcare Alliance | $73 - $2,761 | 68% |
| Quiktrip | $77 - $2,114 | 72% |
| Medica | $89 - $1,894 | 83% |
| Wellfit/Centrus | $96 - $2,111 | 90% |
| Multiplan | $96 - $2,468 | 90% |
| Blue Cross Blue Shield | $96 - $2,404 | 90% |
| Centivo | $99 - $2,111 | 93% |
| Aetna | $99 - $2,209 | 93% |
| Humana | $100 - $2,160 | 94% |
| Orscheln | $101 - $2,111 | 95% |
| Nebraska Furniture Mart | $102 - $2,111 | 95% |
| Mercy Health | $112 - $2,436 | 105% |
| Coxhealth Network | $113 - $2,404 | 106% |
| Coventry Health Care Of Kansas | $125 - $2,404 | 117% |
| National Preferred Provider Network | $135 - $2,923 | 126% |
Consumer Guidance & Cost Commentary
For this CT scan of the pelvis at Children's Mercy South in Overland Park, KS, the facility's cash price of $816.00 is significantly lower than the gross chargemaster rate of $1,701.00. While the facility is a voluntary non-profit, patients with high-deductible plans may find paying cash directly more cost-effective than using insurance, as many commercial payers have negotiated rates that exceed the cash price. For instance, UnitedHealthcare's lowest negotiated rate is $44, but their highest allowed amount reaches $2,183, which is well above the cash rate. To minimize out-of-pocket costs, patients should explicitly ask for "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the administrative overhead and higher administrative markups embedded in insurance contracts.
When comparing pricing against federal benchmarks, the facility's Medicare rate of $106.81 serves as the objective baseline for evaluating commercial pricing. The cash price of $816.00 represents approximately 7.6 times the Medicare rate, which aligns with the typical commercial markup range of 200% to 300% (or higher) often seen in the healthcare industry. It is important to note that while the "vs_medicare" ratio of 1.1 in the data appears to reflect a specific metric, the raw cash price remains the most relevant figure for self-pay patients. If you choose to use insurance, be aware that balance billing protections under the No Surprises Act may apply if you receive out-of-network emergency care at this in-network facility, and you should never sign away your rights to