CMS Price Transparency Data

CT scan, pelvis

Facility: Stanly Regional Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $850
Cash Discount Price: $1,390
vs. Medicare Baseline: 7.96x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Stanly Regional Medical Center is $850. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,390. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.96x the Medicare baseline. Located in 301 Yadkin St, Albemarle, NC.

Cash / Self-Pay

$1,390

Average discount available for prompt cash payment at this facility.

Insurance Median

$850

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: $1,390 (1301%)

Insurance Median: $850 (796%)

Cash: $1,390 (1301% of Medicare)

Ins. Median: $850 (796% 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 796% of the Medicare baseline (a markup of 696%). 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
Trillium	$45 - $347	42%
Alliance	$46 - $343	43%
Amerihealth Caritas	$46 - $340	43%
Carolina Complete Health	$46 - $337	43%
Healthy Blue	$46 - $337	43%
Partners	$46 - $334	43%
UnitedHealthcare	$46 - $1,882	43%
Vaya	$46 - $340	43%
Wellcare	$46 - $337	43%
Cigna	$48 - $2,223	45%
Humana	$49 - $126	46%
Aetna	$50 - $2,501	47%
Blue Cross Blue Shield	$432 - $746	404%
Ambetter / Centene	$850 - $1,034	796%
Employers Health Network	$1,228 - $1,606	1150%
Physician Reach Out	$1,390	1301%
Magellan	$1,668	1562%
Medcost	$1,770 - $2,668	1657%
Gmmi	$1,807	1692%
Quik Trip	$1,807	1692%
Carolina Behavioral Health	$2,001 - $2,223	1873%
First Health	$2,501	2342%
Healthgram	$2,501	2342%
Choicecare	$2,613	2446%
Lifesynch Community Choice Care	$2,613	2446%
Multiplan	$2,613	2446%
Private Health Care Systems	$2,613	2446%
Beechstreet	$2,668	2498%

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 $1,390.
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 Stanly 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.