CMS Price Transparency Data

CT scan, pelvis

Facility: Frances Mahon Deaconess Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $663
Cash Discount Price: $1,155
vs. Medicare Baseline: 6.21x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Frances Mahon Deaconess Hospital is $663. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,155. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.21x the Medicare baseline. Located in 621 3Rd St S, Glasgow, MT.

Cash / Self-Pay

$1,155

Average discount available for prompt cash payment at this facility.

Insurance Median

$663

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: $1,155 (1081%)

Insurance Median: $663 (621%)

Cash: $1,155 (1081% of Medicare)

Ins. Median: $663 (621% 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 621% of the Medicare baseline (a markup of 521%). 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
Ihs-All Plans	$50 - $1,045	47%
UnitedHealthcare	$50 - $2,158	47%
Blue Cross Blue Shield	$57 - $2,113	53%
Humana	$57 - $1,045	53%
Montana Co-Op-All Plans	$89 - $2,204	83%
Cigna	$100 - $2,158	94%
First Choice Health-All Plans	$236 - $2,158	221%
Allegiance Mt	$251 - $2,158	235%
Geha-All Plans	$274 - $2,204	257%
Interwest-All Plans	$274 - $2,158	257%
Health Infonet-All Plans	$280 - $2,158	262%
Multiplan-All Plans	$280 - $2,158	262%
Pacific Source-All Plans	$280 - $2,158	262%
Three Rivers-All Plans	$280 - $2,158	262%

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 $1,155.
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 Frances Mahon Deaconess 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.