CMS Price Transparency Data

CT scan, pelvis

Facility: Chelsea Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,344
  • Cash Discount Price: $1,314
  • vs. Medicare Baseline: 12.58x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Chelsea Hospital is $1,344. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,314. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.58x the Medicare baseline. Located in 775 S Main St, Chelsea, MI.
Cash / Self-Pay
$1,314

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,344

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: $1,314 (1230%)
Insurance Median: $1,344 (1258%)
Cash: $1,314 (1230% of Medicare)
Ins. Median: $1,344 (1258% 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 1258% of the Medicare baseline (a markup of 1158%). 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
Blue Cross Blue Shield $58 - $134 54%
Medicaid / KanCare $58 - $60 54%
Aetna $102 - $944 95%
Blue Care Network Advantage $102 95%
Medicare (plans) $102 - $105 95%
Geha $104 - $1,358 97%
Meritain $104 97%
Align Senior Care $105 98%
Angela Hospice $105 98%
Arbor Hospice $105 98%
Heartland Hospice $105 98%
UnitedHealthcare $108 - $1,358 101%
Cca - Zing Health $111 104%
Longevity Ipa Of Michigan Llc Health Plan Isnp $118 110%
Bcn Domestic $134 125%
Blue Benefit Administrators Of Massachusetts $134 125%
Blue Care Network $134 125%
Blue Distinction Transplant $134 125%
Blue Shield - Ca $134 125%
Blue Shield - Id (Regence) $134 125%
Blue Shield - Ny Highmark Northeastern $134 125%
Blue Shield - Ny Highmark Western $134 125%
Blue Shield - Pa (Highmark) $134 125%
Blue Shield - Wa (Regence) $134 125%
Health Choices $134 - $1,344 125%
Kaiser Domestic $134 125%
Molina Marketplace $136 127%
Health Cost Solutions $162 152%
Vitalcore $162 152%
Wellpath $162 152%
Employee Benefit Logistic $235 220%
Priority Health $294 - $327 275%
U Of M Health Plan $296 277%
Asr Health Benefits $368 345%
Caresource $368 345%
Hap $368 - $1,570 345%
Varipro $368 345%
Wc Accident Fund $534 500%
Wc Advantage $534 500%
Wc Aig $534 500%
Wc Allied $534 500%
Wc Amerisure $534 500%
Wc Amtrust $534 500%
Wc Asu Risk Mgt $534 500%
Wc Berkley Admin $534 500%
Wc Broadspire $534 500%
Wc Bunch & Associates $534 500%
Wc Ccmsi $534 500%
Wc Emc Insurance Company $534 500%
Wc Esis $534 500%
Wc Fcci $534 500%
Wc Federated $534 500%
Wc Gallagher Bassett $534 500%
Wc Genex Care For Ohio $534 500%
Wc Guard Insurance Company $534 500%
Wc Hartford $534 500%
Wc Liberty Mutual $534 500%
Wc Meijers $534 500%
Wc Michigan $534 500%
Wc Mitchell Frankenmuth $534 500%
Wc Pma $534 500%
Wc Sedgwick $534 500%
Wc Sentry $534 500%
Wc Travelers $534 500%
Wc Tristar $534 500%
Wc Walmart $534 500%
Wc Zurich $534 500%
Access Health $1,344 1258%
Acclaim $1,344 1258%
Administrative Concepts $1,344 1258%
Allegeant $1,344 1258%
Ameriben $1,344 1258%
American Family $1,344 1258%
American Healthcare Alliance $1,344 1258%
American National $1,344 1258%
American Republic $1,344 1258%
Amerihealth $1,344 1258%
Aultcare $1,344 1258%
Automated Benefit Services $1,344 1258%
Auxiant $1,344 1258%
Benefit Administrative Systems,Llc $1,344 1258%
Boon Chapman $1,344 1258%
Cam Administrative Services $1,344 1258%
Christian Brother Services $1,344 1258%
Christian Brothers Holy Cross $1,344 1258%
Comprehensive Benefits $1,344 1258%
Continental Life Insurance $1,344 1258%
Custom Benefit Administrators $1,344 1258%
Employee Benefit Concepts $1,344 1258%
Employee Benefit Management $1,344 1258%
Enterprise Group Planning $1,344 1258%
Freedom Life Insurance Company $1,344 1258%
Group Administrators $1,344 1258%
Group Marketing Services $1,344 1258%
Guardian $1,344 1258%
Health America $1,344 1258%
Healthcare Management Admin $1,344 1258%
Healthez $1,344 1258%
Humana $1,344 1258%
Insight $1,344 1258%
Intercare $1,344 1258%
Jfp Benefit Management $1,344 1258%
Jp Farley Corporation $1,344 1258%
Key Benefit Administrator $1,344 1258%
Liberty Union Life Assurance Co $1,344 1258%
Lucent Health $1,344 1258%
Luminare Health $1,344 1258%
Luminare Health (Detroit) $1,344 1258%
Magnacare $1,344 1258%
Medben $1,344 1258%
Medcost $1,344 1258%
Medical Mutual $1,344 1258%
Mutual Health Services $1,344 1258%
Mutual Of Omaha $1,344 1258%
Ncas $1,344 1258%
Nippon Life Ins $1,344 1258%
Nova $1,344 1258%
Painters Union Insurance Fund $1,344 1258%
Physicians Mutual $1,344 1258%
Plumbers Local 98 Insurance Fund $1,344 1258%
Prairie States $1,344 1258%
Preferred One $1,344 1258%
Primary Physician Care $1,344 1258%
Professional Benefit Administrators $1,344 1258%
Siho Insurance Services $1,344 1258%
Sisco Benefits $1,344 1258%
The Loomis Company $1,344 1258%
Unicare $1,344 1258%
Us Health And Life $1,344 1258%
Valenz $1,344 1258%
Western & Southern Financial Group $1,344 1258%
Wps $1,344 1258%
Coventry $1,381 1293%
First Health $1,381 1293%
Hospice Of Michigan $1,415 1325%
Cigna $1,426 1335%
1199 National Benefit Fund $1,516 1419%
Allied National Global Care $1,516 1419%
Asrm - Reliance Standard Life Insurance $1,516 1419%
Christian Care Ministry $1,516 1419%
Dean Health $1,516 1419%
Fallon Health $1,516 1419%
Family Life Insurance Company $1,516 1419%
Ghc Scw $1,516 1419%
Group Pension Administrators $1,516 1419%
International Benefit Administrators $1,516 1419%
Lifetime Benefit Solutions $1,516 1419%
Manhattan Life $1,516 1419%
Medi Share $1,516 1419%
Multiplan $1,516 1419%
Mvp $1,516 1419%
Pai $1,516 1419%
Pan-American Life $1,516 1419%
Paramount Hmo $1,516 1419%
Phcs $1,516 1419%
Trinity Health Share $1,516 1419%
Health Partners $1,570 1470%
Tufts Health Plan $1,570 1470%
Prime Health Services $1,617 1514%
Three Rivers Provider Network $1,819 1703%
Cmh Detroit Wayne Integrated Health Network $2,021 1892%
Cmh Jackson County/Lifeways $2,021 1892%
Cmh Lenawee County $2,021 1892%
Cmh Livingston County $2,021 1892%
Cmh Misc $2,021 1892%
Cmh Monroe County $2,021 1892%
Cmh Washtenaw County $2,021 1892%
Magellan Behavioral Health $2,021 1892%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 775 S Main St, Chelsea, MI 48118
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals