CMS Price Transparency Data

CT scan, pelvis

Facility: Albany Medical Center Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $121
  • Cash Discount Price: $169
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Albany Medical Center Hospital is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $169. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.13x the Medicare baseline. Located in 43 New Scotland Avenue, Mail Code 34, Albany, NY.
Cash / Self-Pay
$169

Average discount available for prompt cash payment at this facility.

Insurance Median
$121

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: $169 (158%)
Insurance Median: $121 (113%)
Cash: $169 (158% of Medicare)
Ins. Median: $121 (113% 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
Cdphp $33 - $819 31%
Blue Cross Blue Shield $36 - $819 34%
Medicare (plans) $36 - $143 34%
Fidelis $38 - $819 36%
Tricare $41 - $126 38%
Hamaspik $45 - $855 42%
Medicaid / KanCare $45 - $157 42%
Blue Shield Highmark $47 - $536 44%
UnitedHealthcare $48 - $2,260 45%
Mvp $49 - $364 46%
Aetna $50 - $397 47%
Nascentia $53 - $138 50%
Emblem Health Ghi $54 - $277 51%
Cigna $76 - $241 71%
Blue Shield $88 - $386 82%
Nys Department Of Corrections $121 - $314 113%
Empire Plan Nyship $128 - $2,260 120%
Multiplan $136 - $2,401 127%
Nascentia Health Options $188 176%
Emblem $194 - $319 182%
Mvp Commercial $282 264%
Emblem_Ghi $319 299%
Mvp Essential Plan $783 733%
Magnacare $4,998 4679%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 43 New Scotland Avenue, Mail Code 34, Albany, NY 12208
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals