CMS Price Transparency Data

CT scan, pelvis

Facility: Daniels Memorial Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $2,235
Cash Discount Price: $3,571
vs. Medicare Baseline: 20.93x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Daniels Memorial Hospital is $2,235. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,571. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.93x the Medicare baseline. Located in 105 5Th Ave E, Scobey, MT.

Cash / Self-Pay

$3,571

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,235

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: $3,571 (3343%)

Insurance Median: $2,235 (2093%)

Cash: $3,571 (3343% of Medicare)

Ins. Median: $2,235 (2093% 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 2093% of the Medicare baseline (a markup of 1993%). 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
Allegiance Comml-All Other Plans	$42 - $5,748	39%
Allegiance Mcr	$42 - $3,630	39%
UnitedHealthcare	$42 - $5,687	39%
Triwest Ccn-All Plans	$50 - $3,630	47%
First Choice Health -All Plans	$222	208%
Pacific Source Comml-All Plans	$233 - $5,748	218%
Geha - All Plans	$1,953 - $5,022	1828%
Montana Health Co-Op Hpn	$2,000 - $5,142	1872%
Blue Cross Blue Shield	$2,052 - $5,276	1921%
Montana Health Co-Op-All Other Plans	$2,235 - $5,748	2093%
Interwest Ppo - All Plans	$2,282 - $5,868	2137%

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 $3,571.
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 Daniels Memorial 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.