CMS Price Transparency Data

CT scan, pelvis

Facility: Elizabethtown Community Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $173
Cash Discount Price: $1,206
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Elizabethtown Community Hospital is $173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,206. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.62x the Medicare baseline. Located in 75 Park Street, Elizabethtown, NY.

Cash / Self-Pay

$1,206

Average discount available for prompt cash payment at this facility.

Insurance Median

$173

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: $1,206 (1129%)

Insurance Median: $173 (162%)

Cash: $1,206 (1129% of Medicare)

Ins. Median: $173 (162% 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
Capital District Physicians' Health Plan	$85 - $1,858	80%
UnitedHealthcare	$88 - $2,081	82%
Humana	$101 - $119	95%
Fidelis Care	$107 - $859	100%
Mvp	$107 - $1,765	100%
Blue Cross Blue Shield	$113 - $1,699	106%
Harvard Pilgrim	$122 - $1,808	114%
Magnacare	$122 - $1,808	114%
Aetna	$126 - $1,695	118%
Martins Point	$126 - $859	118%
Veterans Affairs Community Care Network	$126 - $859	118%
Coventry	$129 - $1,921	121%
Multiplan	$137 - $2,034	128%
Choicecare	$138 - $1,808	129%
Highmark Blueshield	$160 - $1,842	150%
Wellpath	$176 - $1,288	165%
Emblem Health	$1,808	1693%

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 $1,206.
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 Elizabethtown Community 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.