CMS Price Transparency Data

CT scan, pelvis

Facility: Pawhuska Hospital, Inc

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,226
Cash Discount Price: $967
vs. Medicare Baseline: 11.48x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Pawhuska Hospital, Inc is $1,226. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $967. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.48x the Medicare baseline. Located in 1101 East 15Th Street, Pawhuska, OK.

Cash / Self-Pay

$967

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,226

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: $967 (905%)

Insurance Median: $1,226 (1148%)

Cash: $967 (905% of Medicare)

Ins. Median: $1,226 (1148% 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 1148% of the Medicare baseline (a markup of 1048%). 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
Community Care Comm - All Plans	$267	250%
Healthchoice Ip/Op Only - All Plans	$336	315%
Blue Cross Blue Shield	$871 - $1,418	815%
Aetna	$967 - $1,668	905%
Tricare	$967	905%
UnitedHealthcare	$967 - $1,201	905%
Wellcare Mcr Adv - All Plans	$967	905%
Humana	$977 - $1,668	915%
Healthcare Highways - All Plans	$1,084	1015%
Cigna	$1,134	1062%
Multiplan - All Plans	$1,251	1171%
Ambetter / Centene	$1,451	1358%
Preferred Commchoice Ip/Op Only - All Plans	$1,501	1405%
Soonerselect Mcaid - All Plans	$1,668	1562%

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 $967.
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 Pawhuska Hospital, Inc 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.