CMS Price Transparency Data

CT scan, pelvis

Facility: Queens Hospital Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $292
Cash Discount Price: $127
vs. Medicare Baseline: 2.73x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Queens Hospital Center is $292. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.73x the Medicare baseline. Located in 82-68 164Th Street, Jamaica, NY.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$292

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: $127 (119%)

Insurance Median: $292 (273%)

Cash: $127 (119% of Medicare)

Ins. Median: $292 (273% 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 273% of the Medicare baseline (a markup of 173%). 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
Healthfirst	$44 - $863	41%
Aetna	$55 - $1,131	51%
Amidacare	$55 - $383	51%
Emblem	$55 - $518	51%
Wellcare	$59 - $165	55%
Metroplus	$71 - $863	66%
Fidelis	$79 - $863	74%
Oscar	$82 - $1,228	77%
Blue Cross Blue Shield	$126 - $880	118%
Vaccn	$126	118%
Vnsny	$126 - $935	118%
Centers Plan For Healthy Living	$131 - $159	123%
Affinity	$134 - $863	125%
United	$140 - $880	131%
Centerlight	$152 - $550	142%
Elderplan	$152 - $715	142%
Hamaspik	$160	150%
Oxford	$292 - $660	273%
Local 1199	$370 - $935	346%
Carelon	$383 - $715	359%
Senior Whole Health	$383	359%
United Behavioral Health	$383 - $422	359%
Carelon (Amida Care)	$391	366%
Magnacare	$825	772%
Multiplan	$880	824%
Villagecare Max	$935	875%
Cigna	$1,056	989%

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 $127.
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 Queens Hospital Center 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.