CMS Price Transparency Data

CT scan, pelvis

Facility: Cheshire Medical Center

Billing Code: 72192 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$125

about 1.2× the $107 Medicare rate · typically $115–$129

modeled estimate · not a bill or quote

What this hospital charges insurers

$128

About the fair price

about $3 over the fair price · 1.2× Medicare

Medicare pays $107 Fair price $125 This hospital $128 Cash price $426 Hospital's list price $1,542

How we calculate the fair BaseRate →

How this hospital compares to other NH hospitals

One of the lower prices — 6 of 8 other NH hospitals charge more for the same procedure.

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 $125 (about 1.2× the $107 Medicare rate). Cheshire Medical Center charges insurers about $128, or about $426 in cash — about the fair price. Located in Keene, 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	$54 - $1,938	51%
Blue Cross Blue Shieldmajor	$54 - $2,029	51%
Aetnamajor	$51 - $1,747	48%
Cignamajor	$54 - $1,264	51%
Ambetter (Centene)	$54 - $99	51%
AmeriHealth	$65 - $313	61%
Harvard Pilgrim	$113 - $1,161	106%
MVP Health Care	$54 - $1,264	51%
Tufts Health Plan	$151 - $1,630	141%
WellCare	$54 - $111	51%
WellSense	$54 - $352	51%
+ 5 smaller / regional plans	$54 - $2,554

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 426), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72192.

Insurance Before you use insurance

Call your insurance company to confirm Cheshire Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 72192.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Cheshire Medical Center

Compare: CT scan, pelvis at other NH hospitals

Insurance negotiated median for the same procedure, sorted lowest first.