CMS Price Transparency Data

CT scan, pelvis

Facility: Kaleida Health

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $138
  • Cash Discount Price: $454
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Kaleida Health is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $454. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.29x the Medicare baseline. Located in 100 High Street, Buffalo, NY.
Cash / Self-Pay
$454

Average discount available for prompt cash payment at this facility.

Insurance Median
$138

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: $454 (425%)
Insurance Median: $138 (129%)
Cash: $454 (425% of Medicare)
Ins. Median: $138 (129% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Molina Healthcare Of New York, Inc. $45 42%
Highmark Wny $47 - $62 44%
UnitedHealthcare $47 - $142 44%
Independent Health Association $76 - $249 71%
Independent Health Association - Wchob $79 - $249 74%
Univera Healthcare $85 80%
Blue Cross Blue Shield $89 - $487 83%
Ghi/Emblem Health $93 - $176 87%
Ghi/Emblem Health - Wchob $93 - $116 87%
Aetna $97 - $138 91%
Magnacare $97 - $124 91%
Magnacare - Wchob $97 - $124 91%
Tricare $124 116%
Univera $128 - $594 120%
Wellcare $136 127%
Fidelis $141 132%
Cigna $153 - $185 143%
Univera - Wchob $177 - $594 166%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 High Street, Buffalo, NY 14210
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals