CMS Price Transparency Data

CT scan, pelvis

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $221
  • Cash Discount Price: $646
  • vs. Medicare Baseline: 2.07x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Cincinnati Children's Hospital Medical Center is $221. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $646. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.07x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.
Cash / Self-Pay
$646

Average discount available for prompt cash payment at this facility.

Insurance Median
$221

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: $646 (605%)
Insurance Median: $221 (207%)
Cash: $646 (605% of Medicare)
Ins. Median: $221 (207% 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 207% of the Medicare baseline (a markup of 107%). 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
Blue Cross Blue Shield $34 - $2,231 32%
Aetna $35 - $2,156 33%
Mhs_In $35 - $87 33%
Caresource_In $36 - $92 34%
Passport_Ky $36 - $590 34%
Humana $37 - $568 35%
United_Health_Care_Ky $37 - $599 35%
Wellcare_Ky $37 - $597 35%
Caresource_Oh $66 - $274 62%
Amerihealth_Caritas_Oh $68 - $296 64%
Molina_Oh $69 - $302 65%
Buckeye_Oh $72 - $315 67%
United_Health_Care_Oh $79 - $289 74%
Caresource_Oh_Insurance $127 - $1,090 119%
Medical_Mutual_Of_Ohio_Insurance $142 - $2,156 133%
Parkview_Signature_Care_Insurance $162 - $1,771 152%
Point_Comfort_Insurance $172 - $1,476 161%
Margaret_Mary_Health_Insurance $176 - $1,771 165%
United_Health_Care_Insurance $202 - $2,034 189%
Beechstreet_Insurance $214 - $2,225 200%
Cigna $214 - $2,156 200%
Health_Ohio_Network_Insurance $241 - $2,156 226%
Custom_Design_Benefits_Insurance $252 - $2,156 236%
Health_Smart_Preferred_Insurance $252 - $2,156 236%
Medical_Benefit_Administrators_Insurance $252 - $2,156 236%
Ohio_Health_Choice_Insurance $252 - $2,156 236%
Private_Health_Care_Systems_Insurance $254 - $2,179 238%
First_Health_Group_Insurance $260 - $2,225 243%
Health_Link_Insurance $260 - $2,225 243%
Evolutions_Health_Care_Systems $265 - $2,270 248%
Galaxy_Health_Insurance $265 - $2,270 248%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 Burnet Avenue, Cincinnati, OH 45229
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens