CMS Price Transparency Data

CT scan, pelvis

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 72192 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$164
about 1.5× the $107 Medicare rate · typically $120–$187
modeled estimate · not a bill or quote
What this hospital charges insurers
$180
About the fair price
about $16 over the fair price · 1.7× Medicare
Medicare pays $107 Fair price $164 This hospital $180 Cash price $575 Hospital's list price $1,880

How we calculate the fair BaseRate →

How this hospital compares to other NH hospitals

A typical price — 3 charge more and 5 charge less, among the 9 NH hospitals compared.

Cheapest $84 Priciest $419

Black dot = this hospital, among the 9 NH hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, pelvis is about $164 (about 1.5× the $107 Medicare rate). Mary Hitchcock Memorial Hospital charges insurers about $180, or about $575 in cash — about the fair price. Located in Lebanon, NH.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $50 - $2,148 47%
Blue Cross Blue Shieldmajor $50 - $2,437 47%
Aetnamajor $51 - $2,433 48%
Cignamajor $51 - $1,919 48%
Ambetter (Centene) $52 - $256 49%
AmeriHealth $80 - $317 75%
Harvard Pilgrim $62 - $1,794 58%
MVP Health Care $50 - $1,874 47%
Tufts Health Plan $167 - $1,632 156%
WellCare $52 - $124 49%
WellSense $44 - $342 41%
+ 7 smaller / regional plans $50 - $2,657
Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 1 Medical Center Drive, Lebanon, NH 03756
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals