CMS Price Transparency Data

CT scan, pelvis

Facility: The Children's Mercy Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $113
Cash Discount Price: $816
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at The Children's Mercy Hospital is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $816. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.06x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.

Cash / Self-Pay

$816

Average discount available for prompt cash payment at this facility.

Insurance Median

$113

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: $816 (764%)

Insurance Median: $113 (106%)

Cash: $816 (764% of Medicare)

Ins. Median: $113 (106% 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.

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
UnitedHealthcare	$44 - $2,183	41%
Healthy Blue	$48 - $273	45%
Medicaid / KanCare	$48 - $70	45%
Cigna	$50 - $2,257	47%
Home State Health	$50 - $240	47%
Healthlink	$66 - $2,858	62%
Wppa Providrs Care	$66 - $2,111	62%
Health Midwest Comprehensive Care	$70 - $2,114	66%
American Healthcare Alliance	$73 - $2,761	68%
Quiktrip	$77 - $2,114	72%
Medica	$89 - $1,894	83%
Blue Cross Blue Shield	$96 - $2,404	90%
Multiplan	$96 - $2,468	90%
Wellfit/Centrus	$96 - $2,111	90%
Aetna	$99 - $2,209	93%
Centivo	$99 - $2,111	93%
Humana	$100 - $2,160	94%
Orscheln	$101 - $2,111	95%
Nebraska Furniture Mart	$102 - $2,111	95%
Mercy Health	$112 - $2,436	105%
Coxhealth Network	$113 - $2,404	106%
Coventry Health Care Of Kansas	$125 - $2,404	117%
National Preferred Provider Network	$135 - $2,923	126%

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 $816.
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 The Children's Mercy 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.