CMS Price Transparency Data

CT scan, pelvis

Facility: St Francis Hospital - the Heart Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $245
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.29x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at St Francis Hospital - the Heart Center is $245. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.29x the Medicare baseline. Located in 100 Port Washington Boulevard, Roslyn, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$245

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%)
Insurance Median: $245 (229%)
Ins. Median: $245 (229% 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 229% of the Medicare baseline (a markup of 129%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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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 $123 - $336 115%
Aetna $126 - $2,384 118%
Centerlight Healthcare $126 - $141 118%
Centers Plan For Healthy Living $126 118%
Elderplan Inc. $126 - $141 118%
Emblem Health $126 - $283 118%
Fidelis Care New York $126 - $318 118%
Health Plus $126 - $318 118%
Healthspring $126 118%
Independent Health $126 - $141 118%
Liberty Health $126 118%
Longevity Health Plan $126 118%
Medicare (plans) $126 - $132 118%
Mvp Health Plans $126 - $1,643 118%
Orthonet - Uniformed Services Family Health Plan $126 118%
Pmc $126 118%
Senior Whole Health $126 - $141 118%
Tricare $126 118%
UnitedHealthcare $126 - $336 118%
Universal Healthcare $126 118%
Us Family Health Plan $126 118%
Veterans Affairs $126 118%
Health First $127 - $318 119%
Humana $128 120%
Agewell New York $130 122%
Partners Health Plan $132 124%
Wellcare Health Plan Inc $138 129%
Affinity Health Plan $141 - $318 132%
Medicaid / KanCare $141 132%
Surest $245 229%
Zadroga $256 240%
American Plan Administrators $283 265%
Amerihealth Administrators $283 265%
Benefit Services $283 265%
Ghi Cbp Ny City Employee Alternate $283 265%
International Benefit Administrator $283 265%
Ultra Benefits Inc. $283 265%
Self Pay $336 315%
Brighton $674 - $2,104 631%
Local 1199 $1,208 1131%
Oscar Health $1,232 1153%
Apwu $1,643 1538%
Centivo $1,643 - $1,835 1538%
Cigna $1,643 - $2,104 1538%
Daniel H Cook $1,643 1538%
Nalc $1,643 1538%
Samba $1,643 1538%
Allied Wellfare Fund $2,104 1970%
American Group Administrators $2,104 1970%
Bakery & Confectionery Union $2,104 1970%
Comprehensive Benefits Consultant $2,104 1970%
Guardian Life Insurance Company Of America $2,104 1970%
Maloney And Assoc $2,104 1970%
Multiplan $2,104 1970%
Performax $2,104 1970%
Phcs $2,104 1970%
Pomco $2,104 1970%
Tpa Inc $2,104 1970%
Unicare $2,104 1970%
United Employees Health Plan $2,104 1970%
Coventry $2,224 - $2,495 2082%
Mail Handlers Benefit Plan $2,384 2232%
Meritain Health $2,384 2232%
Nippon Life Insurance Company Of America $2,384 2232%
Salvation Army $2,384 2232%
Galaxy $2,705 2533%
Three Rivers Provider Network $2,705 2533%
Aither Health $3,006 2814%
Alpha Care $3,006 2814%
Dentaquest $3,006 2814%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Port Washington Boulevard, Roslyn, NY 11576
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals