CMS Price Transparency Data

CT scan, pelvis

Facility: UPMC Carlisle

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $574
Cash Discount Price: $876
vs. Medicare Baseline: 5.37x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at UPMC Carlisle is $574. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $876. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.37x the Medicare baseline. Located in 361 Alexander Spring Road, Carlisle, PA.

Cash / Self-Pay

$876

Average discount available for prompt cash payment at this facility.

Insurance Median

$574

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: $876 (820%)

Insurance Median: $574 (537%)

Cash: $876 (820% of Medicare)

Ins. Median: $574 (537% 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 537% of the Medicare baseline (a markup of 437%). 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
UnitedHealthcare	$88 - $1,075	82%
Blue Cross Blue Shield	$101 - $799	95%
Humana	$102	95%
Aetna	$106 - $714	99%
Cigna	$107 - $589	100%
Geisinger	$107 - $1,055	100%
Pa Health & Wellness	$110 - $192	103%
Amerihealth Caritas	$143	134%
Highmark Wholecare (Prev Gateway)	$143	134%
Upmc Health Plan	$146 - $1,022	137%
Health Partners Plans (Jefferson Health Plan)	$153	143%
Keystone Autism Services	$163	153%
Prime Net	$200 - $1,104	187%
Onecall	$250	234%
Premier Comp Solutions	$280	262%
Keystone Health Plan	$292 - $799	273%
Upmc Work Partners	$661	619%
Wellspan Population Health	$949 - $1,168	888%
Multiplan	$1,241	1162%

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 $876.
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 UPMC Carlisle 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.