CMS Price Transparency Data

CT scan, pelvis

Facility: Mid-Columbia Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $127
  • Cash Discount Price: $618
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Mid-Columbia Medical Center is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $618. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.19x the Medicare baseline. Located in 1700 E 19Th Street, The Dalles, OR.
Cash / Self-Pay
$618

Average discount available for prompt cash payment at this facility.

Insurance Median
$127

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: $618 (579%)
Insurance Median: $127 (119%)
Cash: $618 (579% of Medicare)
Ins. Median: $127 (119% 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.

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 $49 - $7,690 46%
Community Hp Mcr Adv - All Plans $49 - $124 46%
Molina Mcr Adv $49 - $124 46%
Tricare $49 - $124 46%
Va Ccn Triwest - All Plans $49 - $124 46%
Healthnet Mcr Adv $50 - $127 47%
Humana $51 - $131 48%
Moda Mcr Adv $51 - $124 48%
Devoted Mcr Adv - All Plans $53 - $2,605 50%
Employee Health Plan - All Plans $54 - $224 51%
Molina - All Other Plans $54 - $137 51%
Aetna $58 - $2,226 54%
Healthnet - All Other Plans $74 69%
Cigna $82 - $2,272 77%
Multiplan/Phcs - All Plans $84 - $2,291 79%
Molina Mcaid $85 - $1,254 80%
Coventry - All Plans $95 - $2,171 89%
First Choice - All Plans $97 - $2,291 91%
Providence Ppo - All Plans $102 - $2,291 95%
Moda Health Plan - All Other Plans $106 - $1,592 99%
Amerigroup Mcaid - All Plans $163 - $1,254 153%
Coordinated Care Mcaid - All Plans $163 - $1,254 153%
Norocor - All Plans $1,206 1129%
UnitedHealthcare $1,254 - $2,291 1174%
Healthscape - All Plans $1,930 1807%
First Health - All Plans $2,147 2010%
Pacific Source - All Plans $2,219 2078%
Trpn - Three Rivers - All Plans $2,291 2145%
Ahp - Americas Hlth Plan - All Plans $2,340 2191%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1700 E 19Th Street, The Dalles, OR 97058
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals