CMS Price Transparency Data

CT scan, pelvis

Facility: Holmes County Hospital and Clinics

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,081
Cash Discount Price: $610
vs. Medicare Baseline: 10.12x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Holmes County Hospital and Clinics is $1,081. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $610. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.12x the Medicare baseline. Located in 239 Bowling Green Road, Lexington, MS.

Cash / Self-Pay

$610

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,081

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: $610 (571%)

Insurance Median: $1,081 (1012%)

Cash: $610 (571% of Medicare)

Ins. Median: $1,081 (1012% 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 1012% of the Medicare baseline (a markup of 912%). 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
Ms-Can-Molina-Lex	$83	78%
Ms-Can-Magnolia-Lex	$84	79%
Ms-Can-Truecare-Lex	$85	80%
Molina-Chip-Lex	$178	167%
Magnolia-Chip-Lex	$182	170%
Truecare-Chip-Lex	$182	170%
Advhealth-Lex	$242	227%
Blue Cross Blue Shield	$355	332%
United-Lex	$899	842%
Tricare	$936	876%
Humana	$952	891%
Mpcn-Lex	$992	929%
Medadv_Uhc-Lex	$1,037	971%
United-Options-Lex	$1,045	978%
Firstchoice-Lex	$1,068	1000%
Cigna	$1,093	1023%
Ambetter / Centene	$1,144	1071%
Medadv_Primewell-Lex	$1,144	1071%
Medicare (plans)	$1,144	1071%
Primewell-Lex	$1,144	1071%
Va_Ccn-Lex	$1,144	1071%
Medadv_Uhcdsnp-Lex	$1,179	1104%
Wellcare-Lex	$1,179	1104%
Ppoplus	$1,190	1114%
Devoted_Health-Lex	$1,202	1125%
Firsthealth-Lex	$1,221	1143%
Multiplan-Lex	$1,221	1143%
Aetna	$1,297	1214%
Phcs-Lex	$1,373	1285%
Molina_Exchange-Lex	$1,526	1429%

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 $610.
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 Holmes County Hospital and Clinics 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.