CMS Price Transparency Data

CT scan, pelvis

Facility: Mercy Hospital Tishomingo Inc

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,390
  • Cash Discount Price: $1,738
  • vs. Medicare Baseline: 13.01x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Mercy Hospital Tishomingo Inc is $1,390. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,738. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.01x the Medicare baseline. Located in 1000 South Byrd St, Tishomingo, OK.
Cash / Self-Pay
$1,738

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,390

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: $1,738 (1627%)
Insurance Median: $1,390 (1301%)
Cash: $1,738 (1627% of Medicare)
Ins. Median: $1,390 (1301% 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 1301% of the Medicare baseline (a markup of 1201%). 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
Aetna $71 - $1,778 66%
Humana $71 - $2,139 66%
Medicaid / KanCare $71 - $802 66%
Health Choice Contracted [320166] $292 273%
Ambetter / Centene $802 751%
Blue Cross Blue Shield $802 - $1,390 751%
Home State Health Plan Contracted [320187] $802 751%
Novasys Contracted [320285] $802 751%
Webtpa Contracted [320417] $1,123 1051%
Medicare (plans) $1,233 - $1,711 1154%
Cherokee Nation Health Serv Contracted [320066] $1,285 1203%
Cross Timbers Hospice [20098] $1,285 1203%
Dept Of Veteran Affairs Contracted [320106] $1,285 1203%
Elara Caring Aspire Hospice Contracted [320433] $1,285 1203%
Elara Caring Aspire Hospice [20433] $1,285 1203%
Halo Hcr Inc Hospice Contracted [320432] $1,285 1203%
Halo Hcr Inc Hospice [20432] $1,285 1203%
Independent Health [20197] $1,285 1203%
Indian Health Service Contracted [320198] $1,285 1203%
Kindful Hospice Contracted [320434] $1,285 1203%
Kindful Hospice [20434] $1,285 1203%
Medical Associates Health [20444] $1,285 1203%
Mercy Hospice Okc [20252] $1,285 1203%
Provider Partners Health Plans Contracted [320450] $1,285 1203%
Qual Choice Contracted [320325] $1,285 1203%
Tribute Health Plan Mcr Contracted [320338] $1,285 1203%
Tricare $1,285 1203%
UnitedHealthcare $1,285 - $2,110 1203%
Globalhealth Contracted [320145] $1,311 1227%
Cigna $1,324 - $2,006 1240%
Aither Health Contracted [320449] $1,604 - $2,273 1502%
Mercy Benefit Admin Contracted [320251] $1,604 - $2,273 1502%
Quik Trip Contracted [320447] $1,604 1502%
Show-Me Health Administrators Contracted [320483] $1,604 1502%
Medica Contracted [320239] $1,711 1602%
First Health Contracted [320128] $1,778 1665%
Osma Health Contracted [320292] $1,872 1753%
Benefit Management Contracted [320052] $2,006 - $2,407 1878%
Healthcare Highways Plus Contracted [320175] $2,006 1878%
Private Health Care Systems Contracted [320320] $2,006 - $2,139 1878%
United Medical Resources Contracted [320454] $2,110 1975%
Multiplan Contracted [320270] $2,139 - $2,407 2003%
Auxiant Contracted [320462] $2,273 2128%
Ebms Contracted [320493] $2,273 2128%
Healthlink Contracted [320179] $2,273 2128%
Imagine 360 Contracted [320494] $2,273 2128%
Preferred Community Choice Contracted [320311] $2,273 2128%
Reflect Health Contracted [320492] $2,273 2128%
Yuzu Health Contracted [320521] $2,273 2128%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 South Byrd St, Tishomingo, OK 73460
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals