CMS Price Transparency Data

CT scan, pelvis

Facility: Merit Health River Oaks

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $95
  • Cash Discount Price: $568
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Merit Health River Oaks is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $568. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.89x the Medicare baseline. Located in 1030 River Oaks Drive, Flowood, MS.
Cash / Self-Pay
$568

Average discount available for prompt cash payment at this facility.

Insurance Median
$95

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: $568 (532%)
Insurance Median: $95 (89%)
Cash: $568 (532% of Medicare)
Ins. Median: $95 (89% 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 $11 - $945 10%
Cigna $15 - $1,233 14%
Self Pay $16 - $1,363 15%
UnitedHealthcare $20 - $1,655 19%
Trimed Billing Solutions $22 - $1,859 21%
Ms State Hospital Of Whitfield Ms $28 - $2,355 26%
First Choice Standard $34 - $2,851 32%
First Choice Coventry $39 - $3,222 37%
First Choice Mpcn Standard $41 - $3,408 38%
First Choice Ppo Plus $41 - $3,408 38%
Phcs $45 - $3,718 42%
Benefit Administration Services $54 - $5,267 51%
Benefit Management Systems $54 - $5,267 51%
Citizens State Bank Inc $54 - $5,267 51%
First Choice Stratose $59 - $4,958 55%
Prime Health Services $59 - $4,958 55%
American Health Group $63 - $5,267 59%
Beech Street $63 - $5,267 59%
Formost $63 - $5,267 59%
Usa Mco $63 - $5,267 59%
One Health Plan $67 - $5,577 63%
Ms Dept Of Rehabilitation Services $74 - $6,197 69%
Veterans Eval Services $74 - $90 69%
Magnolia Mcd Chip $82 77%
Caresource Truecare $83 78%
Molina Chip $88 82%
Tricare $90 84%
Humana $93 87%
Medicare (plans) $93 87%
Node First Choice Shared Health Of Ms Mcr Adv $93 87%
Node Vantage Health Mcr Adv $93 87%
Node Champva $94 88%
Node Hospice Non Par Agree $94 88%
Node Va $94 88%
Molina $95 89%
Node Devoted Health Mcr Adv $95 89%
Node First Choice American Health Mcr Adv $95 89%
Aetna $96 - $400 90%
Node First Choice Wellcare Mcr Adv $96 90%
Node Healthy Mississippi Mcr Adv $104 97%
Node Us Dept Of Labor $118 110%
First Choice Preferred $142 133%
Node First Choice Occunet $142 133%
Node First Choice Seven Corners $160 150%
Ms Work Comp $163 153%
Prime Health Wc $163 153%
Magnolia Exchange $165 154%
Molina Exchange $171 160%
First Choice Lgp $206 193%
Vantage Health Commercial $212 198%
Advanced Health Systems $242 227%
Blue Cross Blue Shield $355 332%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1030 River Oaks Drive, Flowood, MS 39232
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals