CMS Price Transparency Data

CT scan, pelvis

Facility: Essentia Health Virginia

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $886
  • Cash Discount Price: $1,185
  • vs. Medicare Baseline: 8.30x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Essentia Health Virginia is $886. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,185. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.30x the Medicare baseline. Located in 901 9Th Street North, Virginia, MN.
Cash / Self-Pay
$1,185

Average discount available for prompt cash payment at this facility.

Insurance Median
$886

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: $1,185 (1109%)
Insurance Median: $886 (830%)
Cash: $1,185 (1109% of Medicare)
Ins. Median: $886 (830% 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 830% of the Medicare baseline (a markup of 730%). 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
Advocare/Security Health $104 97%
Blue Cross Blue Shield $104 - $1,604 97%
Freedom Blue Ppo $104 97%
Healthpartners Care Msho / Mcr Adv $104 97%
Imcare Msho Pcc Prime $104 97%
Imcare Msho Ref Req $104 97%
Medica Advantage Solutions $104 97%
Medica Msho/Dual Solutions $104 97%
Medica Prime Solution Group $104 97%
Medicare (plans) $104 97%
Nd Va Administration $104 97%
Platinum Blue/Vantage Blue $104 97%
Primewest Msho $104 97%
Secure Blue Msho $104 97%
Ubh Cost Plan $104 97%
Ubh Msho $104 97%
Ucare Msho $104 97%
UnitedHealthcare $104 - $1,661 97%
Itasca Med Care $106 99%
Primewest $106 99%
Sanford Healthplan $188 - $852 176%
Medica Access $434 406%
Healthpartners Care Pmap $751 703%
Blue Plus Pmap Pcc Prime $886 - $1,267 830%
Medica $1,202 - $1,336 1125%
Medica Uplan $1,202 1125%
Ucare $1,242 1163%
Healthpartners $1,347 - $1,706 1261%
Wea $1,359 - $1,453 1272%
Medica Choice $1,376 1288%
Security Health $1,453 1360%
America'S Ppo $1,462 1369%
Wps $1,566 - $1,585 1466%
Aetna $1,604 1502%
Cigna $1,700 - $1,706 1592%
Healthpartners Pcc Prime $1,700 - $1,706 1592%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 9Th Street North, Virginia, MN 55792
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals