CMS Price Transparency Data

CT scan, pelvis

Facility: The University of Vermont Health Network - Champl

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $116
Cash Discount Price: $1,655
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at The University of Vermont Health Network - Champl is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,655. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.09x the Medicare baseline. Located in 75 Beekman Street, Plattsburgh, NY.

Cash / Self-Pay

$1,655

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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: $1,655 (1549%)

Insurance Median: $116 (109%)

Cash: $1,655 (1549% of Medicare)

Ins. Median: $116 (109% 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
UnitedHealthcare	$34 - $2,414	32%
Blue Cross Blue Shield	$36 - $2,025	34%
Mvp	$41 - $2,518	38%
Aetna	$48 - $2,256	45%
Capital District Physicians' Health Plan	$48 - $2,494	45%
Fidelis Care	$48 - $130	45%
Humana	$48 - $123	45%
Martins Point	$48 - $139	45%
Veterans Affairs Community Care Network	$48 - $130	45%
Highmark Blueshield	$61 - $2,500	57%
Wellpath	$68 - $195	64%
Harvard Pilgrim	$116 - $2,531	109%
Magnacare	$116 - $2,531	109%
St. Regis	$116 - $130	109%
Coventry	$130 - $2,848	122%
Multiplan	$138 - $3,006	129%
Emblem Health	$2,531	2370%

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 $1,655.
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 The University of Vermont Health Network - Champl 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.