CMS Price Transparency Data

CT scan, pelvis

Facility: Valley Regional Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,723
Cash Discount Price: $11,923
vs. Medicare Baseline: 16.13x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Valley Regional Medical Center is $1,723. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,923. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.13x the Medicare baseline. Located in 100 A Alton Gloor, Brownsville, TX.

Cash / Self-Pay

$11,923

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,723

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: $11,923 (11163%)

Insurance Median: $1,723 (1613%)

Cash: $11,923 (11163% of Medicare)

Ins. Median: $1,723 (1613% 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 1613% of the Medicare baseline (a markup of 1513%). 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
Texas Health Network	$104	97%
Usa Mco	$105	98%
Driscoll Childrens Health Plan	$108	101%
United	$109 - $5,366	102%
Aetna	$115 - $2,309	108%
Molina Healthcare	$115	108%
Blue Cross Blue Shield	$275 - $5,366	257%
Superior Health Plan	$835	782%
Humana	$903	845%
Texas Workforce Commission	$2,862	2680%
Averde Health	$3,935	3684%
Healthsmart Preferred Care	$5,127 - $10,135	4800%
First Health	$6,856	6419%
National Healthcare Solutions	$7,154	6698%
Southwest Medical	$7,154	6698%
Coastal Comp	$7,750	7256%
Total E&P Mexico	$7,750	7256%
Affiliated Healthcare	$8,108	7591%
Mcm Maxcare	$9,539	8931%
Pronet Ppo	$9,539	8931%
Usa Managed Care	$9,539	8931%
Beech Street	$10,731	10047%

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 $11,923.
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 Valley Regional 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.