CMS Price Transparency Data

CT scan, pelvis

Facility: Lancaster General Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $575
  • Cash Discount Price: $1,917
  • vs. Medicare Baseline: 5.38x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Lancaster General Hospital is $575. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,917. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.38x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$1,917

Average discount available for prompt cash payment at this facility.

Insurance Median
$575

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: $1,917 (1795%)
Insurance Median: $575 (538%)
Cash: $1,917 (1795% of Medicare)
Ins. Median: $575 (538% 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 538% of the Medicare baseline (a markup of 438%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $68 - $207 64%
UnitedHealthcare $74 - $1,629 69%
Gateway $79 74%
Tricare $96 90%
Highmark $105 - $1,917 98%
Albright Life $106 99%
Coatesville Va $106 99%
Hospice Generic $106 99%
Lebanon Veterans Hospital $106 99%
Medicare (plans) $106 - $117 99%
Aetna $107 - $1,189 100%
Amerihealth Caritas $108 101%
Blue Cross Blue Shield $108 - $1,629 101%
Cigna $109 - $1,447 102%
Health Partners Mcr Advantage $109 102%
Devoted Health $112 105%
Pa Health And Wellness Mcr $112 105%
Elap Employees $151 141%
Upmc For You $168 157%
Oscar Health Plan $207 194%
Claim Watcher Plus $319 299%
Claim Watcher $350 328%
Hospice And Community Care $364 341%
Elap Other Groups $387 362%
Old Order Group $518 - $613 485%
Lg Coresource/Lg Eliance $546 511%
Lancashire Hall $575 - $1,917 538%
Nursing Home Op Services $575 538%
Affilia Home Health $767 - $1,917 718%
Masonic Homes $805 - $1,917 754%
Eliance Health Solutions $1,227 1149%
Highmark Commercial Preferred $1,283 - $1,917 1201%
Ehp $1,572 1472%
Upmc Commercial $1,572 - $1,629 1472%
Devon $1,629 1525%
Geisinger Commercial $1,629 1525%
Intergroup Services $1,629 1525%
Preferred Healthcare $1,629 1525%
Medi-Share Christian Care $1,821 1705%
Commercial Generic $1,917 1795%
Highmark Commercial Non-Preferred $1,917 - $1,933 1795%
Magellan $1,917 1795%
United Behavioral Health $1,917 1795%
Value Options $1,917 1795%
Workers Compensation $1,917 1795%
Gift Of Life Donor Program $13,500 12639%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals