CMS Price Transparency Data

CT scan, pelvis

Facility: Garrett Regional Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $135
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Garrett Regional Medical Center is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.26x the Medicare baseline. Located in 251 North Fourth Street, Oakland, MD.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$135

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%)

Insurance Median: $135 (126%)

Ins. Median: $135 (126% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Caresource Wv	$129	121%
Aetna	$132 - $143	124%
Carefirst D-Snp	$132	124%
Carefirst Ppo	$132	124%
Humana	$132	124%
Medicare (plans)	$132	124%
Provider Partners	$132	124%
Senior Advantage	$132	124%
United Mine Workers Of America	$132 - $143	124%
UnitedHealthcare	$132 - $143	124%
Amerigroup	$135	126%
Carefirst Community Health Plan	$135	126%
Coventry	$135	126%
Highmark Health Options Wv	$135	126%
Maryland Physicians Care	$135	126%
The Health Plan Of Wv	$135	126%
Wellpoint Wv	$135	126%
Multiplan	$136	127%
Upmc Commercial	$142	133%
Alliance Coal	$143	134%
American Correctional Healthcare	$143	134%
Carefirst Commercial	$143	134%
Cigna	$143	134%
First Health	$143	134%
John Hopkins Healthcare	$143	134%
Peak Commercial	$143	134%
Stratose/ 4 Most	$143	134%
The Health Plan	$143	134%
The Health Plan Commercial	$143	134%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72192.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Garrett Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72192.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.