CMS Price Transparency Data

CT scan, pelvis

Facility: St Louis Childrens Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $828
Cash Discount Price: $697
vs. Medicare Baseline: 7.75x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at St Louis Childrens Hospital is $828. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $697. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.75x the Medicare baseline. Located in One Childrens Place, Saint Louis, MO.

Cash / Self-Pay

$697

Average discount available for prompt cash payment at this facility.

Insurance Median

$828

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: $697 (653%)

Insurance Median: $828 (775%)

Cash: $697 (653% of Medicare)

Ins. Median: $828 (775% 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 775% of the Medicare baseline (a markup of 675%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$103 - $917	96%
Blue Cross Blue Shield	$103 - $987	96%
Essence Healthcare [221]	$103	96%
Humana	$103 - $865	96%
UnitedHealthcare	$103 - $863	96%
Cox Health [757]	$108	101%
Medica [662]	$108	101%
Healthlink [225]	$563 - $877	527%
Cigna	$574 - $630	537%
Consociate [478]	$629	589%
Sarah Bush Lincoln [636]	$629	589%
Apwu Health Plan [216]	$630	590%
Nalc Health Benefit Plan [242]	$630	590%
Priority Health [648]	$630	590%
Cox Health Systems Insurance Company [220]	$639 - $859	598%
Allied Benefits [498]	$673 - $917	630%
Hope Trust [806]	$673	630%
Healthscope Benefits [258]	$708 - $929	663%
Med-Pay [480]	$755 - $871	707%
Unicare [568]	$755 - $877	707%
First Health Commercial [734]	$863	808%
Beechstreet [551]	$871	815%
Detego Health [868]	$871	815%
Health Systems Inc [620]	$871	815%
Healthcare Sol Mercy [609]	$871	815%
Multiplan Commercial [737]	$871	815%
Multiplan [240]	$871	815%
Phcs [244]	$871 - $929	815%
Preferred Health Professionals [561]	$877	821%
Coresource [497]	$917	859%
Fmh Benefit Service Inc [222]	$917	859%
Mail Handlers [495]	$917	859%
Medica [661]	$929	870%
Hfn [563]	$987	924%
Health Alliance [224]	$1,700	1592%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $697.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72192.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Louis Childrens Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72192.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.