CMS Price Transparency Data

CT scan, pelvis

Facility: Memorial Hospital for Cancer and Allied Diseases

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $460
Cash Discount Price: $1,139
vs. Medicare Baseline: 4.31x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Memorial Hospital for Cancer and Allied Diseases is $460. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,139. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.31x the Medicare baseline. Located in 1275 York Ave, New York, NY.

Cash / Self-Pay

$1,139

Average discount available for prompt cash payment at this facility.

Insurance Median

$460

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: $1,139 (1066%)

Insurance Median: $460 (431%)

Cash: $1,139 (1066% of Medicare)

Ins. Median: $460 (431% 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 431% of the Medicare baseline (a markup of 331%). 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
Aetna	$55 - $1,685	51%
Fidelis	$55 - $954	51%
Healthfirst	$55 - $1,196	51%
Metroplus	$55 - $1,295	51%
Emblem	$157 - $1,381	147%
Oxford	$196 - $1,863	184%
Empire	$205 - $712	192%
Magnacare	$205 - $1,594	192%
Urn	$222 - $1,415	208%
6 Degrees Health	$228 - $1,555	213%
UnitedHealthcare	$244 - $1,985	228%
Cigna	$246 - $677	230%
Multiplan	$256 - $1,794	240%

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 $1,139.
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 Memorial Hospital for Cancer and Allied Diseases 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.