CMS Price Transparency Data

CT scan, pelvis

Facility: Johnson City Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $140
Cash Discount Price: $588
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Johnson City Medical Center is $140. 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 1.31x the Medicare baseline. Located in 400 N State of Franklin Rd, Johnson City, TN.

Cash / Self-Pay

$588

Average discount available for prompt cash payment at this facility.

Insurance Median

$140

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: $140 (131%)

Cash: $588 (551% of Medicare)

Ins. Median: $140 (131% 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.

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
Aetna	$98 - $2,500	92%
Amerigroup	$98 - $109	92%
Humana	$98	92%
Managed Medicaire	$98	92%
Medicare (plans)	$98	92%
Mountain Empire Pace	$98	92%
Sentara Health	$98 - $1,367	92%
United Mine Workers Of America	$98	92%
UnitedHealthcare	$98 - $3,820	92%
Blue Cross Blue Shield	$100 - $524	94%
Molina Healthcare	$101 - $140	95%
Cigna	$102 - $542	95%
Devoted Health Plan	$102	95%
Nhc Advantage	$102	95%
Wellcare	$103 - $3,918	96%
Optima Health	$135	126%
Ambetter / Centene	$213	199%
Medcost	$1,371	1284%
First Health Coventry	$2,938	2751%
Seven Corners, Inc.	$3,918	3668%

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 $588.
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 Johnson City 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.