CMS Price Transparency Data

CT scan, pelvis

Facility: Atrium Health Lincoln

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $767
Cash Discount Price: $1,390
vs. Medicare Baseline: 7.18x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Atrium Health Lincoln is $767. 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 7.18x the Medicare baseline. Located in 433 McAlister Rd, Lincolnton, NC.

Cash / Self-Pay

$1,390

Average discount available for prompt cash payment at this facility.

Insurance Median

$767

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: $767 (718%)

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

Ins. Median: $767 (718% 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 718% of the Medicare baseline (a markup of 618%). 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 - $329	42%
Alliance	$46 - $326	43%
Amerihealth Caritas	$46 - $314	43%
Carolina Complete Health	$46 - $319	43%
Healthy Blue	$46 - $319	43%
Partners	$46 - $322	43%
UnitedHealthcare	$46 - $1,584	43%
Vaya	$46 - $322	43%
Wellcare	$46 - $319	43%
Cigna	$48 - $1,876	45%
Humana	$49 - $126	46%
Aetna	$50 - $2,362	47%
Orthocarolina	$60 - $154	56%
Blue Cross Blue Shield	$797 - $1,414	746%
Ambetter / Centene	$909 - $1,034	851%
Employers Health Network	$1,228	1150%
Medcost	$1,309 - $1,818	1226%
Physician Reach Out	$1,390	1301%
Gmmi	$1,807	1692%
Quik Trip	$1,807	1692%
Choicecare	$2,279	2134%
First Health	$2,362	2211%
Beechstreet	$2,501	2342%
Private Health Care Systems	$2,501	2342%
Multiplan	$2,640	2472%

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 Atrium Health Lincoln 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.