CMS Price Transparency Data

CT scan, pelvis

Facility: Wellmont Holston Valley Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $167
  • Cash Discount Price: $588
  • vs. Medicare Baseline: 1.56x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Wellmont Holston Valley Medical Center is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $588. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.56x the Medicare baseline. Located in 130 West Ravine Road, Kingsport, TN.
Cash / Self-Pay
$588

Average discount available for prompt cash payment at this facility.

Insurance Median
$167

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: $588 (551%)
Insurance Median: $167 (156%)
Cash: $588 (551% of Medicare)
Ins. Median: $167 (156% 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.

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
Aetna $99 - $1,673 93%
Humana $99 93%
Managed Medicaire $99 93%
Medicare (plans) $99 93%
Sentara Health $99 - $1,011 93%
United Mine Workers Of America $99 93%
UnitedHealthcare $99 - $3,026 93%
Blue Cross Blue Shield $101 - $355 95%
Amerigroup $103 96%
Cigna $104 - $642 97%
Devoted Health Plan $104 97%
Molina Healthcare $104 - $140 97%
Mountain Empire Pace $104 97%
Nhc Advantage $104 97%
Wellcare $105 - $3,918 98%
Optima Health $137 128%
Ambetter / Centene $216 202%
Seven Corners, Inc. $238 223%
Medcost $1,865 1746%
First Health Coventry $3,017 2825%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 130 West Ravine Road, Kingsport, TN 37662
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals