CMS Price Transparency Data

CT scan, pelvis

Facility: Montefiore Mount Vernon Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $151
  • Cash Discount Price: $657
  • vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Montefiore Mount Vernon Hospital is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $657. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.41x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
$657

Average discount available for prompt cash payment at this facility.

Insurance Median
$151

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: $657 (615%)
Insurance Median: $151 (141%)
Cash: $657 (615% of Medicare)
Ins. Median: $151 (141% 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
Blue Cross Blue Shield $130 122%
Emblem $130 - $808 122%
Fidelis $130 - $247 122%
Healthfirst $130 - $226 122%
Metroplus $130 - $170 122%
Point Comfort $130 122%
UnitedHealthcare $130 - $245 122%
Villagecaremax $130 122%
Vnsny Choice $130 - $163 122%
Wellcare $133 - $144 125%
Centerlight $134 - $144 125%
Elderplan $134 125%
Partners Health Plan $137 128%
Medicaid / KanCare $141 132%
Longevity $142 133%
Humana $144 135%
Vnsny Select Health $163 153%
Molina Healthcare Of Ny Affinity $180 169%
Oscar $206 193%
American Postal Workers $245 229%
Mvp $266 249%
Northwell $351 329%
Aetna $402 - $450 376%
Centivo $636 595%
Cigna $1,970 - $2,189 1844%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals