CMS Price Transparency Data

CT scan, pelvis

Facility: Cleveland Clinic

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $228
  • Cash Discount Price: $441
  • vs. Medicare Baseline: 2.13x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Cleveland Clinic is $228. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $441. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.13x the Medicare baseline. Located in 9500 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
$441

Average discount available for prompt cash payment at this facility.

Insurance Median
$228

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: $441 (413%)
Insurance Median: $228 (213%)
Cash: $441 (413% of Medicare)
Ins. Median: $228 (213% 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 213% of the Medicare baseline (a markup of 113%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Summacare $31 - $324 29%
Aetna $48 - $1,072 45%
Blue Cross Blue Shield $48 - $577 45%
Devoted Health $48 - $123 45%
Humana $48 - $577 45%
The Health Plan $48 - $590 45%
United $48 - $327 45%
UnitedHealthcare $48 - $686 45%
Upmc $48 - $643 45%
Valor $48 - $123 45%
Cigna $50 - $858 47%
Communicare $51 - $129 48%
Perennial Health $52 - $133 49%
Pphp $52 - $135 49%
Zing Health $53 - $135 50%
Cc Ehp $92 - $424 86%
Mmo $99 - $1,170 93%
Oscar $105 - $286 98%
Paramount $127 - $198 119%
Buckeye $130 - $201 122%
Caresource $130 - $192 122%
Amerihealth $136 127%
Molina $136 - $201 127%
Ohcp $153 - $417 143%
Ohio Healthy $157 - $475 147%
Aultcare $169 - $461 158%
Amish Community Aid Plan $177 - $482 166%
Omas $196 - $536 184%
United Bh $211 198%
Healthsmart $216 - $590 202%
Phphi $236 - $643 221%
Clarity Health $255 - $697 239%
Gms $275 - $750 257%
Quality Care Partners $275 - $750 257%
Consociate Health $295 - $804 276%
Multiplan $354 - $965 331%
Three Rivers $354 - $965 331%
Usa Managed Care $354 - $965 331%
Php $407 381%
Medical Benefit Corp $475 445%
Parkview Health Plan $475 445%
Community Health Alliance $543 508%
Frontpath $611 572%
Managed Care Services $611 572%
Tertiary Care Network $611 572%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9500 Euclid Avenue, Cleveland, OH 44195
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals