CMS Price Transparency Data

CT scan, pelvis

Facility: Ohio Valley Surgical Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,156
  • Cash Discount Price: $770
  • vs. Medicare Baseline: 10.82x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Ohio Valley Surgical Hospital is $1,156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $770. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.82x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$770

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,156

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: $770 (721%)
Insurance Median: $1,156 (1082%)
Cash: $770 (721% of Medicare)
Ins. Median: $1,156 (1082% 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 1082% of the Medicare baseline (a markup of 982%). 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
Aarp $101 - $11,885 95%
Aarp Supplemental $101 - $11,885 95%
Aetna $101 - $20,896 95%
American Continental Insurance $101 - $11,885 95%
American Continental Life $101 - $11,885 95%
American Republic $101 - $11,885 95%
American Retirement $101 - $11,885 95%
Aultcare Primetime Health Plan $101 - $11,885 95%
Bankers Fidelity $101 - $11,885 95%
Bankers Life And Casualty $101 - $11,885 95%
Blue Cross Blue Shield $101 - $40,293 95%
Central States $101 - $11,885 95%
Champus $101 - $11,885 95%
Cigna $101 - $18,817 95%
Communicare Advantage $101 - $11,885 95%
Everest $101 - $11,885 95%
Gateway Health Plan $101 - $11,885 95%
Humana $101 - $11,919 95%
Medicare (plans) $101 - $12,264 95%
Medigold $101 - $11,885 95%
Mmoh $101 - $11,885 95%
Molina $101 - $11,885 95%
Molina Dual Mcr $101 - $11,885 95%
Molina Marketplace $101 - $11,885 95%
Molina Dual Mcr $101 - $11,885 95%
Molina Mcr $101 - $11,885 95%
Molina Mcr Mcd $101 - $11,885 95%
Molina Mcr+Mcd $101 - $11,885 95%
Patient No Pay $101 - $11,885 95%
Prosperity Supplement $101 - $11,885 95%
UnitedHealthcare $101 - $17,571 95%
Wellcare By Allwell $101 - $11,885 95%
Wraparound Pl Supp $101 - $11,885 95%
The Health Plan $106 - $12,479 99%
Employer Direct $117 - $15,703 110%
Devoted Health $120 - $13,707 112%
Caresource $152 - $17,827 142%
Caresourse $152 - $17,827 142%
Medicaid / KanCare $152 - $17,827 142%
Geha $162 - $20,896 152%
Genworth $162 - $20,896 152%
Mail Handlers $162 - $20,896 152%
Meritain $162 - $20,896 152%
Meritain Heatlh $162 - $20,896 152%
Mhbp $162 - $20,896 152%
Ngs Coresource $162 - $20,896 152%
Nippon Life $162 - $20,896 152%
Pacific Source $162 - $20,896 152%
Personify Health $162 - $20,896 152%
Healthgram $164 - $18,817 154%
Nalc $164 - $18,817 154%
Samba $164 - $18,817 154%
Sbma $164 - $18,817 154%
Unified Group $164 - $18,817 154%
Golden Rule $178 - $17,571 167%
Medica $178 - $17,571 167%
Oxford $178 - $17,571 167%
Shl $178 - $17,571 167%
Surest $178 - $17,571 167%
Ushealth $178 - $17,571 167%
Self Pay Imaging $230 - $11,885 215%
Mmo Cin. Hmo $591 - $809 553%
Mmoh (Supermed) $591 - $597 553%
Luminare Health $1,156 1082%
Medben $1,156 1082%
Ohio Health $1,156 1082%
Preferred Health $1,156 1082%
Amerihealth Caritas Of Ohio $3,657 3424%
Buckeye Community Health Plan $4,022 3766%
Molina Mcd $4,084 3824%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Main Street, Springfield, OH 45502
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals