CMS Price Transparency Data

CT scan, pelvis

Facility: Incline Village Community Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $307
Cash Discount Price: $1,350
vs. Medicare Baseline: 2.87x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Incline Village Community Hospital is $307. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,350. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.87x the Medicare baseline. Located in 880 Alder Street, Incline Village, NV.

Cash / Self-Pay

$1,350

Average discount available for prompt cash payment at this facility.

Insurance Median

$307

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: $1,350 (1264%)

Insurance Median: $307 (287%)

Cash: $1,350 (1264% of Medicare)

Ins. Median: $307 (287% 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 287% of the Medicare baseline (a markup of 187%). 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
UnitedHealthcare	$45 - $2,142	42%
Medicare (plans)	$49 - $928	46%
Healthnet - All Plans	$67 - $2,261	63%
Blue Cross Blue Shield	$133 - $2,142	125%
Ca Hlth And Wellness - All Plans	$162 - $2,428	152%
Aetna	$282 - $2,094	264%
Prominence Healthfirst - All Plans	$282 - $2,094	264%
Admar Multiplan - All Plans	$288 - $2,142	270%
First Health - All Plans	$288 - $2,142	270%
Great West/One Health - All Plans	$288 - $2,142	270%
Hometown Hp - All Plans	$288 - $2,142	270%
Humana	$288 - $2,142	270%
Interplan - All Plans	$288 - $2,142	270%
Multiplan - All Plans	$288 - $2,142	270%
Phcs - All Plans	$288 - $2,142	270%
Cigna	$294 - $2,190	275%
Beech Street/Capp Care - All Plans	$304 - $2,261	285%
Uhn - All Plans	$304 - $2,261	285%
Sierra Health - All Plans	$310 - $2,309	290%

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 $1,350.
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 Incline Village Community 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.