CMS Price Transparency Data

CT scan, pelvis

Facility: Wilkes Regional Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,064
Cash Discount Price: $1,043
vs. Medicare Baseline: 9.96x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Wilkes Regional Medical Center is $1,064. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,043. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.96x the Medicare baseline. Located in 1370 West D St, North Wilkesboro, NC.

Cash / Self-Pay

$1,043

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,064

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: $1,043 (977%)

Insurance Median: $1,064 (996%)

Cash: $1,043 (977% of Medicare)

Ins. Median: $1,064 (996% 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 996% of the Medicare baseline (a markup of 896%). 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
Healthteam	$105	98%
Amerihealth	$390 - $1,211	365%
Carolina Complete	$390	365%
Healthblue	$390	365%
Partners	$390	365%
UnitedHealthcare	$394 - $1,113	369%
Vaya	$394	369%
Wellcare	$394	369%
Alliance	$398	373%
Trillium	$402	376%
Medcost	$600 - $1,489	562%
Blue Cross Blue Shield	$724 - $1,217	678%
Aetna	$792 - $1,432	742%
Ambetter / Centene	$882 - $1,270	826%
Cigna	$1,093 - $1,130	1023%
Oscar	$1,147 - $1,355	1074%
Directnet	$1,232	1153%
Private Healthcare Systems	$1,876	1756%
Multiplan	$1,918	1796%

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 $1,043.
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 Wilkes Regional Medical Center 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.