CMS Price Transparency Data

CT scan, pelvis

Facility: Riverview Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $541
Cash Discount Price: $118
vs. Medicare Baseline: 5.07x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Riverview Medical Center is $541. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.07x the Medicare baseline. Located in One Riverview Plaza, Red Bank, NJ.

Cash / Self-Pay

$118

Average discount available for prompt cash payment at this facility.

Insurance Median

$541

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: $118 (110%)

Insurance Median: $541 (507%)

Cash: $118 (110% of Medicare)

Ins. Median: $541 (507% 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 507% of the Medicare baseline (a markup of 407%). 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
Karna	$91 - $250	85%
Blue Cross Blue Shield	$118	110%
Vaccn	$118	110%
Wellcare	$118	110%
United Community/Americhoice	$124	116%
Aetna	$128 - $2,196	120%
UnitedHealthcare	$141 - $714	132%
Horizon	$201 - $2,264	188%
Cigna	$255 - $2,244	239%
Oxford	$265	248%
Clover	$505	473%
Amerihealth	$541 - $550	507%
Seoul Medical Group	$609	570%
Activecare First McO	$650	609%
Qualcare	$1,762 - $2,159	1650%
Brighton Health Plan	$1,935	1812%
Bergen Risk	$2,104	1970%
Multiplan - PHCS	$2,384	2232%

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 $118.
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 Riverview 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.