CMS Price Transparency Data

CT scan, pelvis

Facility: North Adams Regional Hospital Corporation

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $713
  • Cash Discount Price: $1,532
  • vs. Medicare Baseline: 6.68x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at North Adams Regional Hospital Corporation is $713. 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 6.68x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$1,532

Average discount available for prompt cash payment at this facility.

Insurance Median
$713

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: $713 (668%)
Cash: $1,532 (1434% of Medicare)
Ins. Median: $713 (668% 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 668% of the Medicare baseline (a markup of 568%). 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
Mcd New York $90 - $108 84%
Mcd Masshealth $108 - $181 101%
Mcd Out Of State $108 - $181 101%
Mcdmanaged Cdphp $108 - $181 101%
Mcdmanaged Hne Mcdaco $108 - $181 101%
Medicaid / KanCare $108 - $709 101%
Comm Network Qhpsub $118 - $911 110%
Mcdmanaged Network $118 - $911 110%
Mcdmanaged Bmchnp $124 - $189 116%
Medicare (plans) $136 - $374 127%
Tricare $137 - $606 128%
Comm Hospice $138 - $371 129%
Mcr Miscellaneous $138 - $371 129%
Mcrmanaged Usa Family $138 - $371 129%
Mcrmanaged Va $138 - $371 129%
Oth United Vaccn $138 - $371 129%
Blue Cross Blue Shield $156 - $1,370 146%
Mcrmanaged Cca One Care $156 - $367 146%
Aetna $163 - $1,217 153%
Comm Fallon Qhp $206 - $913 193%
Comm Hne Hmo $261 - $1,062 244%
Wc Workers Comp $275 - $978 257%
Comm Hne $278 - $1,124 260%
Comm Hne Ppo $278 - $1,129 260%
Comm Unicare $316 - $1,046 296%
Comm Network Qhpnonsub $705 - $1,159 660%
Comm Nhp $713 - $1,043 668%
Comm Tufts $873 - $1,277 817%
UnitedHealthcare $948 - $1,387 888%
Cigna $992 - $1,499 929%
Comm Cdphp $992 - $1,451 929%
Comm Mvp $992 - $1,451 929%
Comm Oxford $992 - $1,451 929%
Comm First Health $1,025 - $1,532 960%
Comm Connecticare $1,047 - $1,532 980%
Comm Consolidated Health $1,047 - $1,532 980%
Comm Harvard $1,047 - $1,532 980%
Comm Other $1,047 - $1,532 980%
Comm Phcs $1,047 - $1,532 980%
Comm Self Pay $1,047 - $1,532 980%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals