CMS Price Transparency Data

CT scan, pelvis

Facility: Southwest General Health Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $196
  • Cash Discount Price: $1,446
  • vs. Medicare Baseline: 1.84x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Southwest General Health Center is $196. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,446. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.84x the Medicare baseline. Located in 18697 Bagley Road, Middleburg Heights, OH.
Cash / Self-Pay
$1,446

Average discount available for prompt cash payment at this facility.

Insurance Median
$196

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: $1,446 (1354%)
Insurance Median: $196 (184%)
Cash: $1,446 (1354% of Medicare)
Ins. Median: $196 (184% 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.

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
Medical Mutual $42 - $46 39%
Medical Mutual-Ohio $42 - $174 39%
Buckeye $123 - $196 115%
Caresource $123 - $196 115%
Humana $123 - $752 115%
Molina $123 - $196 115%
UnitedHealthcare $123 - $1,041 115%
Amerihealth Caritas $128 - $196 120%
Blue Cross Blue Shield $174 - $232 163%
Valor Health $174 163%
Healthsmart $617 578%
Health Design Plus $713 668%
Clarity Health $771 722%
Healthspan $771 722%
Healthsmart Preferred $868 813%
Ohio Health Choice Plus $933 874%
Summacare $1,041 975%
Aetna $1,043 977%
Cigna $1,055 988%
Coventry $1,330 1245%
First Health $1,330 1245%
Ohio Health Choice $1,490 1395%
Private Healthare Systems $1,542 1444%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 18697 Bagley Road, Middleburg Heights, OH 44130
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals