CMS Price Transparency Data
CT scan, pelvis
Facility: Mercy Hospital Lincoln
Billing Code: 72192 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72192
- Insurance Median: $270
- Cash Discount Price: $850
- vs. Medicare Baseline: 2.53x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Mercy Hospital Lincoln is $270. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $850. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.53x the Medicare baseline. Located in 1000 East Cherry Street, Troy, MO.
Cash / Self-Pay
$850
Average discount available for prompt cash payment at this facility.
Insurance Median
$270
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: $850 (796%)
Insurance Median: $270 (253%)
Cash: $850 (796% of Medicare)
Ins. Median: $270 (253% 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 253% of the Medicare baseline (a markup of 153%). 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.
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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 | $21 - $1,054 | 20% |
| Aetna | $48 - $1,504 | 45% |
| Tricare | $68 - $491 | 64% |
| Medicare (plans) | $69 - $2,296 | 65% |
| UnitedHealthcare | $70 - $1,515 | 66% |
| Provider Partners Health Plans Contracted [320450] | $74 - $537 | 69% |
| American Health Advantage Of Mo Mcr [10473] | $75 - $540 | 70% |
| Blue Cross Blue Shield | $75 - $1,768 | 70% |
| Cherokee Nation Health Serv Contracted [320066] | $75 - $540 | 70% |
| Cross Timbers Hospice [20098] | $75 - $540 | 70% |
| Dept Of Veteran Affairs Contracted [320106] | $75 - $540 | 70% |
| Elara Caring Aspire Hospice Contracted [320433] | $75 - $540 | 70% |
| Elara Caring Aspire Hospice [20433] | $75 - $540 | 70% |
| Globalhealth Contracted [320145] | $75 - $540 | 70% |
| Halo Hcr Inc Hospice Contracted [320432] | $75 - $540 | 70% |
| Halo Hcr Inc Hospice [20432] | $75 - $540 | 70% |
| Humana | $75 - $2,066 | 70% |
| Indian Health Service Contracted [320198] | $75 - $540 | 70% |
| Kindful Hospice Contracted [320434] | $75 - $540 | 70% |
| Kindful Hospice [20434] | $75 - $540 | 70% |
| Mercy Hospice Okc [20252] | $75 - $540 | 70% |
| Pace Of The Ozarks Contracted [320518] | $75 - $540 | 70% |
| Qual Choice Contracted [320325] | $75 - $540 | 70% |
| Cigna | $80 - $1,906 | 75% |
| Centivo Contracted [320505] | $115 - $833 | 108% |
| Medica Contracted [320239] | $134 - $964 | 125% |
| Ambetter / Centene | $146 - $1,054 | 137% |
| Home State Health Plan Contracted [320187] | $146 - $1,054 | 137% |
| Novasys Contracted [320285] | $146 - $1,054 | 137% |
| Hope Trust Contracted [320488] | $157 - $1,137 | 147% |
| Health Choices Contracted [320448] | $191 - $1,378 | 179% |
| Health Choices [20448] | $191 - $1,378 | 179% |
| Medical Associates Health Contracted [320444] | $191 - $1,378 | 179% |
| First Health Contracted [320128] | $208 - $1,504 | 195% |
| United Medical Resources Contracted [320454] | $210 - $1,515 | 197% |
| Mercy Mgd Behavioral Health Contracted [320259] | $238 | 223% |
| Multiplan Contracted [320270] | $238 - $1,722 | 223% |
| Private Health Care Systems Contracted [320320] | $238 | 223% |
| Workers Comp [20426] | $238 - $1,837 | 223% |
| Healthlink Contracted [320179] | $258 - $2,043 | 242% |
| Aither Health Contracted [320449] | $270 - $1,952 | 253% |
| Aither Health [20449] | $270 - $1,952 | 253% |
| Auxiant Contracted [320462] | $270 - $1,952 | 253% |
| Ebms Contracted [320493] | $270 - $1,952 | 253% |
| Edison Health Solutions Contracted [320502] | $270 - $1,952 | 253% |
| Federal Medical Center Contracted [320127] | $270 - $1,952 | 253% |
| Imagine 360 Contracted [320494] | $270 - $1,952 | 253% |
| Insurance System Inc Contracted [320465] | $270 - $1,952 | 253% |
| Mercy Benefit Admin Contracted [320251] | $270 - $1,952 | 253% |
| Mercy Benefit Admin [20251] | $270 - $1,952 | 253% |
| Point C Contracted [320238] | $270 - $1,952 | 253% |
| Preferred Health Plan Contracted [320522] | $270 - $1,952 | 253% |
| Reflect Health Contracted [320492] | $270 - $1,952 | 253% |
| Show-Me Health Administrators Contracted [320483] | $270 - $1,952 | 253% |
| Tri State Healthcare Coalition Contracted [320379] | $270 - $1,952 | 253% |
| Yuzu Health Contracted [320521] | $270 - $1,952 | 253% |