CMS Price Transparency Data

CT scan, pelvis

Facility: Essentia Health Moose Lake

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,059
  • Cash Discount Price: $1,335
  • vs. Medicare Baseline: 9.91x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Essentia Health Moose Lake is $1,059. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,335. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.91x the Medicare baseline. Located in 4572 County Road 61, Moose Lake, MN.
Cash / Self-Pay
$1,335

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,059

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: $1,335 (1250%)
Insurance Median: $1,059 (991%)
Cash: $1,335 (1250% of Medicare)
Ins. Median: $1,059 (991% 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 991% of the Medicare baseline (a markup of 891%). 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 $72 - $1,264 67%
Blue Plus Pmap Pcc Prime $72 - $993 67%
Itasca Med Care $106 99%
Primewest $106 99%
Medica Access $719 - $1,125 673%
Healthpartners Care Pmap $726 680%
Sanford Healthplan $775 - $815 726%
Advocare/Security Health $849 795%
Freedom Blue Ppo $849 795%
Healthpartners Care Msho / Mcr Adv $849 795%
Imcare Msho Pcc Prime $849 795%
Imcare Msho Ref Req $849 795%
Medica Advantage Solutions $849 795%
Medica Msho/Dual Solutions $849 795%
Medica Prime Solution Group $849 795%
Medicare (plans) $849 795%
Nd Va Administration $849 795%
Platinum Blue/Vantage Blue $849 795%
Primewest Msho $849 795%
Secure Blue Msho $849 795%
Ubh Cost Plan $849 795%
Ubh Msho $849 795%
Ucare Msho $849 795%
UnitedHealthcare $849 - $1,634 795%
Ucare $1,188 1112%
Healthpartners $1,264 - $1,439 1183%
Medica $1,291 - $1,436 1209%
Medica Uplan $1,291 1209%
Wea $1,300 - $1,391 1217%
America'S Ppo $1,400 1311%
Cigna $1,409 - $1,439 1319%
Healthpartners Pcc Prime $1,409 - $1,439 1319%
Medica Choice $1,479 1385%
Wps $1,499 - $1,517 1403%
Aetna $1,535 1437%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4572 County Road 61, Moose Lake, MN 55767
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals