CMS Price Transparency Data

CT scan, pelvis

Facility: Portsmouth Regional Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $660
Cash Discount Price: $6,162
vs. Medicare Baseline: 6.18x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Portsmouth Regional Hospital is $660. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,162. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.18x the Medicare baseline. Located in 333 Borthwick Ave, Portsmouth, NH.

Cash / Self-Pay

$6,162

Average discount available for prompt cash payment at this facility.

Insurance Median

$660

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: $6,162 (5769%)

Insurance Median: $660 (618%)

Cash: $6,162 (5769% of Medicare)

Ins. Median: $660 (618% 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 618% of the Medicare baseline (a markup of 518%). 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
Blue Cross Blue Shield	$216 - $2,730	202%
Amerihealth Caritas	$254	238%
Harvard Pilgrim	$387 - $484	362%
Well Sense Health Plan	$504	472%
United	$1,584 - $4,067	1483%
Maine Community Health	$1,927 - $3,265	1804%
Tufts Health Plan	$2,317 - $3,525	2169%
Aetna	$3,901	3652%
Corvel	$4,437	4154%
Evernorth	$4,930	4616%
Mutual Of Omaha	$4,930	4616%
Multiplan	$4,991	4673%
First Health	$5,607	5250%
Healthcare Value Mgmt	$5,607	5250%
Oxford Health Plans	$5,854	5481%

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 $6,162.
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 Portsmouth Regional Hospital 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.