CMS Price Transparency Data

CT scan, pelvis

Facility: Sanford Canton-Inwood Medical Center - Cah

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,685
Cash Discount Price: $1,815
vs. Medicare Baseline: 15.78x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Sanford Canton-Inwood Medical Center - Cah is $1,685. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,815. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.78x the Medicare baseline. Located in 440 North Hiawatha Drive, Canton, SD.

Cash / Self-Pay

$1,815

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,685

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: $1,815 (1699%)

Insurance Median: $1,685 (1578%)

Cash: $1,815 (1699% of Medicare)

Ins. Median: $1,685 (1578% 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 1578% of the Medicare baseline (a markup of 1478%). 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
Sanford Health Plan Align	$776	727%
Ucare	$833 - $1,994	780%
Wellmark	$833 - $1,974	780%
Aetna	$842 - $1,972	788%
Health Partners	$842 - $1,702	788%
Medicare (plans)	$842	788%
UnitedHealthcare	$842 - $1,895	788%
Primewest	$858	803%
Sanford Health Plan	$1,243 - $1,668	1164%
Security Health Plan	$1,248	1168%
Medica	$1,872 - $2,001	1753%
First Choice Health Network	$2,042	1912%
Healthez	$2,042	1912%
Multiplan	$2,042	1912%

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 $1,815.
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 Sanford Canton-Inwood Medical Center - Cah 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.