CMS Price Transparency Data

CT scan, pelvis

Facility: Hospital of Univ of Pennsylvania

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,107
  • Cash Discount Price: $4,918
  • vs. Medicare Baseline: 10.36x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Hospital of Univ of Pennsylvania is $1,107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,918. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.36x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$4,918

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,107

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: $4,918 (4604%)
Insurance Median: $1,107 (1036%)
Cash: $4,918 (4604% of Medicare)
Ins. Median: $1,107 (1036% 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 1036% of the Medicare baseline (a markup of 936%). 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.

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
Gspp And Wissahickon Hospice $55 51%
Medicaid / KanCare $68 - $4,918 64%
Kaiser Permanente $71 - $4,918 66%
Keystone Mercy Health Plan $86 - $4,918 81%
UnitedHealthcare $97 - $4,918 91%
Upmc $101 - $4,918 95%
Blue Cross Blue Shield $110 - $3,763 103%
Medicare (plans) $110 - $112 103%
Philadelphia Va Medical Center $110 103%
Tricare $110 103%
Ibc $112 105%
Pa Medical Assistance $112 - $4,918 105%
Cigna $113 - $2,213 106%
Geisinger Health Plan $113 - $349 106%
Health Partners $113 - $4,918 106%
Humana $113 - $3,934 106%
Devoted Health $115 108%
Pa Health And Wellness $115 - $181 108%
Penn Life (Living Independently For Elders) $115 108%
Aetna $116 - $4,918 109%
Clover Health Plan $119 111%
Keystone First $122 114%
Us Family Health Plan $126 118%
Gateway Health Plan $136 127%
Paired Kidney Exchange $148 139%
Elap $156 146%
Claims Watcher $176 - $198 165%
Oscar Health Plan $187 175%
Centivo $198 185%
Elap Services $204 191%
Highmark $231 216%
Penn Global Medicine $291 272%
Keystone Hmo Proactive $299 280%
Ibc Commercial Hpn $309 289%
Horizon Nj Health $831 - $865 778%
Preferred Health Care Eliance $1,082 1013%
Pgm - Regie De L'Assurance Maladie Quebec $1,131 1059%
Pgm - Kuwait Defense $1,721 - $2,213 1611%
Qualcare $1,869 1750%
Olympus $1,933 1810%
Coventry $1,967 - $2,508 1842%
Pgm - Chop $1,967 1842%
Wissahickon Hospice $1,967 1842%
Healthamerica/Coventry $2,213 - $2,410 2072%
First Health Global $2,459 2302%
Health Net $2,951 2763%
Pgm - Royal Embassy Of Saudi Arabia $2,951 2763%
Pgm - Embassy Of Qatar $3,197 2993%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $3,197 2993%
Interlink $3,295 3085%
Pgm - Embassy Of The United Emirates/Ipc $3,443 3223%
Health America/Ccn $3,934 3683%
Intergroup $3,934 3683%
Pgm - Kuwait Health Division $3,934 3683%
Pgm - Kuwait Oil $3,934 3683%
Preferred Care $3,934 3683%
Blue Quality Centers For Transplant (Bqct) $4,918 4604%
City Of Philadelphia Behavioral Health $4,918 4604%
Commercial Other $4,918 4604%
International Pfs $4,918 4604%
United Behavioral Health $4,918 4604%
Workers Compensation $4,918 4604%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals