CMS Price Transparency Data

CT scan, pelvis

Facility: Reading Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,131
Cash Discount Price: $1,980
vs. Medicare Baseline: 10.59x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Reading Hospital is $1,131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,980. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.59x the Medicare baseline. Located in 420 S 5Th Avenue, West Reading, PA.

Cash / Self-Pay

$1,980

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,131

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: $1,980 (1854%)

Insurance Median: $1,131 (1059%)

Cash: $1,980 (1854% of Medicare)

Ins. Median: $1,131 (1059% 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 1059% of the Medicare baseline (a markup of 959%). 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
Upmc	$74 - $1,527	69%
Geisinger	$81 - $1,790	76%
Keystone First	$81	76%
Pa Health & Wellness	$84	79%
UnitedHealthcare	$84 - $786	79%
Amerihealth Caritas	$86	81%
Gateway	$86	81%
Health Partners	$86	81%
Wernersville State Hospital	$88	82%
Blue Cross Blue Shield	$127 - $1,690	119%
Aetna	$169 - $1,951	158%
Pma	$1,131	1059%
Lehigh Valley Health Network	$1,273	1192%
Cigna	$1,618	1515%
Berkshire	$2,121	1986%
First Health	$2,178	2039%
Blue Ridge	$2,687	2516%

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 $1,980.
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 Reading 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.