CMS Price Transparency Data

CT scan, pelvis

Facility: Galion Community Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,851
Cash Discount Price: $2,049
vs. Medicare Baseline: 17.33x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Galion Community Hospital is $1,851. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,049. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 17.33x the Medicare baseline. Located in 269 Portland Way South, Galion, OH.

Cash / Self-Pay

$2,049

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,851

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: $2,049 (1918%)

Insurance Median: $1,851 (1733%)

Cash: $2,049 (1918% of Medicare)

Ins. Median: $1,851 (1733% 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 1733% of the Medicare baseline (a markup of 1633%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Caresource	$310	290%
Medicaid / KanCare	$310	290%
Ohiorise	$310	290%
Molina	$316 - $5,629	296%
Blue Cross Blue Shield	$319 - $4,142	299%
Amerihealth	$325	304%
United_Healthcare	$325 - $4,142	304%
Buckeye	$335 - $4,142	314%
Humana	$335 - $4,142	314%
Medicare (plans)	$819 - $4,142	767%
Mount_Carmel	$819 - $4,142	767%
Aetna	$836 - $4,224	783%
Medical_Mutual	$1,928 - $4,224	1805%
Cigna	$2,121	1986%

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 $2,049.
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 Galion 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.