CMS Price Transparency Data

CT scan, pelvis

Facility: Ortonville Area Health Services

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $952
  • Cash Discount Price: $1,349
  • vs. Medicare Baseline: 8.91x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Ortonville Area Health Services is $952. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,349. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.91x the Medicare baseline. Located in 450 Eastvold Ave, Ortonville, MN.
Cash / Self-Pay
$1,349

Average discount available for prompt cash payment at this facility.

Insurance Median
$952

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: $1,349 (1263%)
Insurance Median: $952 (891%)
Cash: $1,349 (1263% of Medicare)
Ins. Median: $952 (891% 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 891% of the Medicare baseline (a markup of 791%). 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 $262 - $1,536 245%
Medica Choicecare/Accessibility Solution/Minnesotacare $491 460%
Medica $762 713%
Medica Minnesota Senior Health Options (Msho)/Select Solution/Prime Solution $762 713%
Primewest $762 713%
Ucare Health $762 713%
UnitedHealthcare $762 - $1,397 713%
Health Partners $794 - $1,416 743%
Sanford Health Plan $1,460 1367%
Multiplan $1,492 1397%
Medica Choice/Focus/Ifb/Mhps/Care System $1,538 1440%
America'S Health System $1,539 1441%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 450 Eastvold Ave, Ortonville, MN 56278
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals