CMS Price Transparency Data

CT scan, pelvis

Facility: Tristar Horizon Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $522
Cash Discount Price: $9,094
vs. Medicare Baseline: 4.89x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Tristar Horizon Medical Center is $522. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,094. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.89x the Medicare baseline. Located in 111 Highway 70 East, Dickson, TN.

Cash / Self-Pay

$9,094

Average discount available for prompt cash payment at this facility.

Insurance Median

$522

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: $9,094 (8514%)

Insurance Median: $522 (489%)

Cash: $9,094 (8514% of Medicare)

Ins. Median: $522 (489% 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 489% of the Medicare baseline (a markup of 389%). 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
United	$155 - $4,092	145%
Humana	$202 - $2,273	189%
Blue Cross Blue Shield	$247 - $444	231%
Aetna	$459 - $4,547	430%
Kentucky Labor Cabinet	$1,674	1567%
Apex Health	$1,728	1618%
Nhc Advantage, Inc.	$1,728	1618%
Pruitt Health (Allyalign)	$1,728	1618%
Cigna	$3,328 - $7,275	3116%
Bgfh Singlesource	$4,547 - $7,730	4257%
Employers Health Network	$6,365	5959%
Multiplan	$8,184	7662%
Beech Street	$8,366	7833%

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 $9,094.
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 Tristar Horizon Medical Center 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.