CMS Price Transparency Data

CT scan, pelvis

Facility: Saratoga Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $55
Cash Discount Price: $1,394
vs. Medicare Baseline: 0.51x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Saratoga Hospital is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,394. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.51x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.

Cash / Self-Pay

$1,394

Average discount available for prompt cash payment at this facility.

Insurance Median

$55

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: $1,394 (1305%)

Insurance Median: $55 (51%)

Cash: $1,394 (1305% of Medicare)

Ins. Median: $55 (51% 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
Cdphp	$33 - $825	31%
Blue Cross Blue Shield	$36 - $1,672	34%
Fidelis	$36 - $825	34%
Medicare (plans)	$36 - $48	34%
Tricare	$41 - $48	38%
Hamaspik	$45 - $861	42%
Medicaid / KanCare	$45	42%
Emblem Health Ghi	$48 - $53	45%
UnitedHealthcare	$48 - $2,508	45%
Aetna	$49 - $1,366	46%
Mvp	$49 - $92	46%
Blue Shield Highmark	$55 - $63	51%
Mvp Commercial	$65 - $1,951	61%
Cigna	$76 - $92	71%
Emblem	$126 - $194	118%
Blue Shield	$169 - $457	158%
Nascentia Health Options	$188	176%
Mvp Essential Plan	$367 - $733	344%
Mvp Govt Programs	$367	344%
Empire Plan Nyship	$1,951	1827%
Multiplan	$2,090 - $2,369	1957%
Magnacare	$2,508 - $2,648	2348%

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 $1,394.
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 Saratoga 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.