CMS Price Transparency Data

CT scan, pelvis

Facility: Fairview Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $721
  • Cash Discount Price: $1,532
  • vs. Medicare Baseline: 6.75x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Fairview Hospital is $721. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,532. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.75x the Medicare baseline. Located in 29 Lewis Avenue, Great Barrington, MA.
Cash / Self-Pay
$1,532

Average discount available for prompt cash payment at this facility.

Insurance Median
$721

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $1,532 (1434%)
Insurance Median: $721 (675%)
Cash: $1,532 (1434% of Medicare)
Ins. Median: $721 (675% of 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 675% of the Medicare baseline (a markup of 575%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Health New England $108 - $1,124 101%
Medicaid / KanCare $108 - $181 101%
Aetna $115 - $1,217 108%
Point32Health $118 - $1,532 110%
Bmchnp $124 - $189 116%
Medicare (plans) $136 - $619 127%
Other Government $137 - $629 128%
Hospice $138 - $629 129%
UnitedHealthcare $138 - $1,387 129%
Capital District Physicians' Health Plan $141 - $1,451 132%
Fallon $142 - $709 133%
Blue Cross Blue Shield $156 - $1,370 146%
Commcare Alliance $163 - $616 153%
Comm Fallon Qhp $206 - $993 193%
Comm Hne Hmo $261 - $1,062 244%
Workers Comp $275 - $1,028 257%
Comm Hne Ppo $278 - $1,129 260%
Unicare $316 - $1,046 296%
Allways Nhp $713 - $1,043 668%
Cigna $992 - $1,499 929%
Mvp $992 - $1,451 929%
Oxford $992 - $1,451 929%
First Health $1,025 - $1,532 960%
Connecticare $1,047 - $1,532 980%
Consolidated Health Plans $1,047 - $1,532 980%
Other Commercial $1,047 - $1,532 980%
Phcs $1,047 - $1,532 980%
Self Pay $1,047 - $1,532 980%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 29 Lewis Avenue, Great Barrington, MA 01230
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals