CMS Price Transparency Data

CT scan, pelvis

Facility: Montefiore New Rochelle Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $141
Cash Discount Price: $571
vs. Medicare Baseline: 1.32x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Montefiore New Rochelle Hospital is $141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $571. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.32x the Medicare baseline. Located in 16 Guion Place, New Rochelle, NY.

Cash / Self-Pay

$571

Average discount available for prompt cash payment at this facility.

Insurance Median

$141

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: $571 (535%)

Insurance Median: $141 (132%)

Cash: $571 (535% of Medicare)

Ins. Median: $141 (132% 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.

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
Healthfirst	$86 - $126	81%
Emblem	$126 - $170	118%
Empire	$126 - $4,641	118%
Fidelis	$126 - $170	118%
Metroplus	$126 - $255	118%
UnitedHealthcare	$126 - $245	118%
Villagecaremax	$126	118%
Vnsny Choice	$126 - $163	118%
Wellcare	$128 - $143	120%
Centerlight	$130	122%
Amidacare	$132 - $141	124%
Partners_Health_Plan	$132	124%
Hamaspik	$136 - $148	127%
Humana	$138	129%
Molina Healthcare Of Ny Affinity	$139 - $312	130%
Medicaid / KanCare	$141	132%
Mvp	$141 - $290	132%
Vnsny Select Health	$163	153%
Oscar	$199	186%
Northwell	$338	316%
Aetna	$425 - $475	398%
Centivo	$553	518%
Cigna	$1,933	1810%

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 $571.
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 Montefiore New Rochelle Hospital 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.