CMS Price Transparency Data
CT scan, pelvis
Facility: Diley Ridge Medical Center
Billing Code: 72192 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72192
- Insurance Median: $566
- Cash Discount Price: $788
- vs. Medicare Baseline: 5.30x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Diley Ridge Medical Center is $566. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $788. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.30x the Medicare baseline. Located in 7911 Diley Road, Canal Winchester, OH.
Cash / Self-Pay
$788
Average discount available for prompt cash payment at this facility.
Insurance Median
$566
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: $788 (738%)
Insurance Median: $566 (530%)
Cash: $788 (738% of Medicare)
Ins. Median: $566 (530% 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 530% of the Medicare baseline (a markup of 430%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $89 - $106 | 83% |
| Aetna | $99 - $1,385 | 93% |
| Blue Cross Blue Shield | $99 - $1,213 | 93% |
| Hospice Mount Carmel | $101 | 95% |
| Oscar | $101 | 95% |
| UnitedHealthcare | $101 - $1,186 | 95% |
| The Health Plan | $103 - $797 | 96% |
| Enterprise Group Planning | $195 | 183% |
| Custom Design Benefits | $211 | 198% |
| Quality Care Partners | $228 | 213% |
| Blue Benefit Administrators Of Massachusetts | $376 | 352% |
| Blue Care Network | $376 | 352% |
| Blue Distinction Transplant | $376 | 352% |
| Blue Shield - Ca | $376 | 352% |
| Blue Shield - Id (Regence) | $376 | 352% |
| Blue Shield - Ny Highmark Northeastern | $376 | 352% |
| Blue Shield - Ny Highmark Western | $376 | 352% |
| Blue Shield - Pa (Highmark) | $376 | 352% |
| Blue Shield - Wa (Regence) | $376 | 352% |
| Geha | $545 - $1,186 | 510% |
| Gravie Admin Services | $545 | 510% |
| Healthez | $545 | 510% |
| Meritain | $545 | 510% |
| Webtpa | $545 | 510% |
| Access Health | $566 | 530% |
| Acclaim | $566 | 530% |
| Administrative Concepts | $566 | 530% |
| Allegeant | $566 | 530% |
| Allied Benefit Systems | $566 | 530% |
| American Family | $566 | 530% |
| American Healthcare Alliance | $566 | 530% |
| American National | $566 | 530% |
| American Republic | $566 | 530% |
| Amerihealth | $566 | 530% |
| Aultcare | $566 | 530% |
| Automated Benefit Services | $566 | 530% |
| Auxiant | $566 | 530% |
| Benefit Administrative Systems,Llc | $566 | 530% |
| Boon Chapman | $566 | 530% |
| Cam Administrative Services | $566 | 530% |
| Christian Brother Services | $566 | 530% |
| Christian Brothers Holy Cross | $566 | 530% |
| Claimchoice Adminstrators | $566 | 530% |
| Comprehensive Benefits | $566 | 530% |
| Continental Life Insurance | $566 | 530% |
| Coventry | $566 | 530% |
| Custom Benefit Administrators | $566 | 530% |
| Cypress Benefit Administrators | $566 | 530% |
| Employee Benefit Concepts | $566 | 530% |
| Employee Benefit Management | $566 | 530% |
| Forest County Potawatomi | $566 | 530% |
| Freedom Life Insurance Company | $566 | 530% |
| Group Administrators | $566 | 530% |
| Group Marketing Services | $566 | 530% |
| Group Pension Administrators | $566 | 530% |
| Guardian | $566 | 530% |
| Health America | $566 | 530% |
| Health Choices | $566 | 530% |
| Healthcare Management Admin | $566 | 530% |
| Insight | $566 | 530% |
| Intercare | $566 | 530% |
| Jfp Benefit Management | $566 | 530% |
| Jp Farley Corporation | $566 | 530% |
| Key Benefit Administrator | $566 | 530% |
| Liberty Union Life Assurance Co | $566 | 530% |
| Lucent Health | $566 | 530% |
| Luminare Health | $566 | 530% |
| Magnacare | $566 | 530% |
| Medcost | $566 | 530% |
| Mutual Health Services | $566 | 530% |
| Mutual Of Omaha | $566 | 530% |
| Ncas | $566 | 530% |
| Nippon Life Ins | $566 | 530% |
| Nova | $566 | 530% |
| Painters Union Insurance Fund | $566 | 530% |
| Physicians Mutual | $566 | 530% |
| Plumbers Local 98 Insurance Fund | $566 | 530% |
| Prairie States | $566 | 530% |
| Preferred One | $566 | 530% |
| Primary Physician Care | $566 | 530% |
| Professional Benefit Administrators | $566 | 530% |
| Secureone Preferred United Plans | $566 | 530% |
| Siho Insurance Services | $566 | 530% |
| Sisco Benefits | $566 | 530% |
| The Loomis Company | $566 | 530% |
| Trustmark Small Business Benefits | $566 | 530% |
| U Of M Health Plan | $566 | 530% |
| Unicare | $566 | 530% |
| Unified Group Services | $566 | 530% |
| Us Health And Life | $566 | 530% |
| Valenz | $566 | 530% |
| Varipro | $566 | 530% |
| Wps | $566 | 530% |
| Medben | $606 - $910 | 567% |
| Humana | $620 - $1,213 | 580% |
| Crime Victim Assistance | $632 | 592% |
| Ohio Safe Program | $632 | 592% |
| First Health | $639 | 598% |
| Consociate | $741 | 694% |
| Health Ohio Network | $741 | 694% |
| Caresource | $885 | 829% |
| Healthlink Inc | $910 | 852% |
| Luminare Health (Detroit) | $910 | 852% |
| Medical Benefits Mutual | $910 | 852% |
| Ohio Health Choice | $910 | 852% |
| Ohio Ppo Connect | $910 | 852% |
| Osu Not Independent Choice | $910 | 852% |
| Medical Mutual | $923 | 864% |
| Medi Share | $969 | 907% |
| Multiplan | $969 | 907% |
| Phcs | $969 | 907% |
| Philadelphia American Life Insurance | $969 | 907% |
| Ameriben | $970 | 908% |
| Ohiohealthy | $970 | 908% |
| Twin Valley Psychiatric | $970 | 908% |
| Health Smart | $1,031 | 965% |
| American Postal Workers Secondary | $1,126 | 1054% |
| Cigna | $1,126 | 1054% |
| Health Partners | $1,126 | 1054% |
| Healthgram | $1,126 | 1054% |
| Mvp | $1,126 | 1054% |
| Priority Health | $1,126 | 1054% |
| Bccp | $1,213 | 1136% |
| Medicaid / KanCare | $1,213 | 1136% |
| Optima Health | $1,213 | 1136% |
| Rural Carrier Health Benefit Plan | $1,370 | 1283% |