CMS Price Transparency Data

CT scan, pelvis

Facility: Pennsylvania Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,617
  • Cash Discount Price: $6,219
  • vs. Medicare Baseline: 15.14x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Pennsylvania Hospital is $1,617. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,219. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.14x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$6,219

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,617

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: $6,219 (5822%)
Insurance Median: $1,617 (1514%)
Cash: $6,219 (5822% of Medicare)
Ins. Median: $1,617 (1514% 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 1514% of the Medicare baseline (a markup of 1414%). 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
Gateway Health Plan $68 - $136 64%
Medicaid / KanCare $68 - $6,219 64%
Keystone Mercy Health Plan $86 81%
Upmc $101 - $6,219 95%
Blue Cross Blue Shield $109 - $6,219 102%
Medicare (plans) $109 - $112 102%
Philadelphia Va Medical Center $109 102%
Tricare $110 103%
Ibc $112 105%
Pa Medical Assistance $112 105%
Cigna $113 - $240 106%
Geisinger Health Plan $113 - $347 106%
Health Partners $113 - $6,219 106%
Humana $113 - $4,975 106%
Pa Health And Wellness $115 - $180 108%
Penn Life (Living Independently For Elders) $115 108%
Aetna $116 - $6,219 109%
UnitedHealthcare $116 - $6,219 109%
Clover Health Plan $118 110%
Keystone First $121 113%
Us Family Health Plan $126 118%
Elap $155 145%
Claims Watcher $175 - $197 164%
Oscar Health Plan $186 174%
Centivo $197 184%
Elap Services $203 190%
Highmark $230 215%
Penn Global Medicine $290 272%
Keystone Hmo Proactive $299 280%
Ibc Commercial Hpn $309 289%
Horizon Nj Health $1,051 - $1,093 984%
Pgm - Regie De L'Assurance Maladie Quebec $1,430 1339%
Preferred Health Care Eliance $1,617 1514%
Pgm - Kuwait Defense $2,177 - $2,799 2038%
Devon $2,363 - $2,799 2212%
Qualcare $2,363 2212%
Coventry $2,488 - $3,172 2329%
Pgm - Chop $2,488 2329%
Wissahickon Hospice $2,488 2329%
Healthamerica/Coventry $2,799 - $3,047 2621%
Olympus $3,022 2829%
First Health Global $3,110 2912%
Urn-Cancer Resource Services $3,110 2912%
Health Net $3,731 3493%
Pgm - Royal Embassy Of Saudi Arabia $3,731 3493%
Pgm - Embassy Of Qatar $4,042 3784%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $4,042 3784%
Pgm - Embassy Of The United Emirates/Ipc $4,353 4075%
Devon Health Services Inc $4,975 4658%
Health America/Ccn $4,975 4658%
Intergroup $4,975 4658%
Pgm - Kuwait Health Division $4,975 4658%
Pgm - Kuwait Oil $4,975 4658%
Preferred Care $4,975 4658%
Commercial Other $6,219 5822%
Community Behavioral Health $6,219 5822%
International Pfs $6,219 5822%
Quest Behavioral Health $6,219 5822%
United Behavioral Health $6,219 5822%
Workers Compensation $6,219 5822%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals