CMS Price Transparency Data
CT scan, pelvis
Facility: Mercy Hospital Washington
Billing Code: 72192 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72192
- Insurance Median: $185
- Cash Discount Price: $1,249
- vs. Medicare Baseline: 1.73x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Mercy Hospital Washington is $185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,249. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.73x the Medicare baseline. Located in 901 East 5Th Street, Washington, MO.
Cash / Self-Pay
$1,249
Average discount available for prompt cash payment at this facility.
Insurance Median
$185
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: $1,249 (1169%)
Insurance Median: $185 (173%)
Cash: $1,249 (1169% of Medicare)
Ins. Median: $185 (173% 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.
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 |
|---|---|---|
| Medicaid / KanCare | $91 - $288 | 85% |
| Aetna | $99 - $288 | 93% |
| American Health Advantage Of Mo Mcr [10473] | $99 | 93% |
| Blue Cross Blue Shield | $99 - $1,729 | 93% |
| Cherokee Nation Health Serv Contracted [320066] | $99 | 93% |
| Cross Timbers Hospice [20098] | $99 | 93% |
| Dept Of Veteran Affairs Contracted [320106] | $99 | 93% |
| Elara Caring Aspire Hospice Contracted [320433] | $99 | 93% |
| Elara Caring Aspire Hospice [20433] | $99 | 93% |
| Globalhealth Contracted [320145] | $99 | 93% |
| Halo Hcr Inc Hospice Contracted [320432] | $99 | 93% |
| Halo Hcr Inc Hospice [20432] | $99 | 93% |
| Humana | $99 | 93% |
| Kindful Hospice Contracted [320434] | $99 | 93% |
| Kindful Hospice [20434] | $99 | 93% |
| Medicare (plans) | $99 - $1,921 | 93% |
| Mercy Hospice Okc [20252] | $99 | 93% |
| Pace Of The Ozarks Contracted [320518] | $99 | 93% |
| Qual Choice Contracted [320325] | $99 | 93% |
| Tricare | $99 | 93% |
| UnitedHealthcare | $99 - $136 | 93% |
| Cigna | $101 - $864 | 95% |
| Hope Trust Contracted [320488] | $101 | 95% |
| Provider Partners Health Plans Contracted [320450] | $109 | 102% |
| Healthscope Contracted [320182] | $126 | 118% |
| United Medical Resources Contracted [320454] | $136 | 127% |
| Centivo Contracted [320505] | $166 | 155% |
| Preferred Health Plan Contracted [320522] | $176 | 165% |
| Aither Health Contracted [320449] | $185 | 173% |
| Aither Health [20449] | $185 | 173% |
| Auxiant Contracted [320462] | $185 | 173% |
| Ebms Contracted [320493] | $185 | 173% |
| Edison Health Solutions Contracted [320502] | $185 | 173% |
| Healthlink Contracted [320179] | $185 - $1,306 | 173% |
| Imagine 360 Contracted [320494] | $185 | 173% |
| Mercy Benefit Admin Contracted [320251] | $185 - $272 | 173% |
| Mercy Benefit Admin [20251] | $185 - $272 | 173% |
| Reflect Health Contracted [320492] | $185 | 173% |
| Show-Me Health Administrators Contracted [320483] | $185 | 173% |
| Yuzu Health Contracted [320521] | $185 | 173% |
| Ambetter / Centene | $229 | 214% |
| Home State Health Plan Contracted [320187] | $229 | 214% |
| Novasys Contracted [320285] | $229 | 214% |
| Medica Contracted [320239] | $261 | 244% |
| Workers Comp [20426] | $525 - $1,537 | 492% |
| Health Choices Contracted [320448] | $1,153 | 1079% |
| Health Choices [20448] | $1,153 | 1079% |
| Medical Associates Health Contracted [320444] | $1,153 | 1079% |
| Federal Medical Center Contracted [320127] | $1,249 | 1169% |
| Insurance System Inc Contracted [320465] | $1,249 | 1169% |
| Point C Contracted [320238] | $1,249 | 1169% |
| Tri State Healthcare Coalition Contracted [320379] | $1,249 | 1169% |
| First Health Contracted [320128] | $1,364 | 1277% |
| Multiplan Contracted [320270] | $1,441 | 1349% |