CMS Price Transparency Data

CT scan, pelvis

Facility: UPMC Muncy

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,158
Cash Discount Price: $1,313
vs. Medicare Baseline: 10.84x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at UPMC Muncy is $1,158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,313. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.84x the Medicare baseline. Located in 215 East Water Street, Muncy, PA.

Cash / Self-Pay

$1,313

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,158

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: $1,313 (1229%)

Insurance Median: $1,158 (1084%)

Cash: $1,313 (1229% of Medicare)

Ins. Median: $1,158 (1084% 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 1084% of the Medicare baseline (a markup of 984%). 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	$86 - $1,497	81%
Geisinger	$124 - $1,467	116%
Upmc Health Plan	$124 - $954	116%
Highmark Wholecare (Prev Gateway)	$125 - $328	117%
Amerihealth Caritas	$127 - $2,208	119%
Pa Health & Wellness	$192 - $2,316	180%
Cigna	$345 - $1,499	323%
Upmc Work Partners	$691	647%
Three Rivers Provider Network	$739 - $1,970	692%
Blue Cross Blue Shield	$859 - $1,011	804%
Aetna	$888 - $1,445	831%
Coventry/First Health	$1,097 - $1,473	1027%
Wirerope Works	$1,217	1139%
Multiplan	$1,707 - $2,080	1598%
America'S Choice	$1,751	1639%
Intergroup	$1,751	1639%

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 $1,313.
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 Muncy 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.