CMS Price Transparency Data

CT scan, pelvis

Facility: Methodist Charlton Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $149
  • Cash Discount Price: $1,958
  • vs. Medicare Baseline: 1.40x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Methodist Charlton Medical Center is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,958. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.40x the Medicare baseline. Located in 3500 W Wheatland Road, Dallas, TX.
Cash / Self-Pay
$1,958

Average discount available for prompt cash payment at this facility.

Insurance Median
$149

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: $1,958 (1833%)
Insurance Median: $149 (140%)
Cash: $1,958 (1833% of Medicare)
Ins. Median: $149 (140% 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
UnitedHealthcare $100 - $110 94%
Aetna $103 - $166 96%
Blue Cross Blue Shield $103 - $767 96%
Covid19 Hrsa Uninsured Testing And Treatment Fund [6005] $103 96%
Medicare (plans) $103 - $110 96%
Ust Health Proof [1005] $103 96%
Wellcare [7016] $103 96%
American Health Advantage Of Texas [7099] $108 101%
Cigna $108 - $190 101%
Globalhealth [1003] $108 101%
Procare Advantage [7018] $108 101%
Humana $109 102%
Southwestern Health Resources Swhr [7015] $109 102%
Provider Partners Health Plan [7025] $111 104%
Coralvita [9216] $123 115%
Alternative Service Concepts [8005] $128 120%
Oscar Insurance Company [2057] $134 125%
Bright Healthcare [2222] $144 135%
Molina [3017] $149 140%
Wellpoint Marketplace Exchange [3071] $159 149%
Kempton Group Administrators, Tower Extrusions [3061] $164 154%
90 Degree Benefit [3057] $169 158%
Allied National [2031] $169 158%
Entrust/90 Degree [2058] $169 158%
Ambetter / Centene $176 165%
Imperial Insurance Companies [3073] $185 173%
Web Tpa [3049] $190 178%
Department Of Labor [8004] $205 192%
Evry Health [1013] $205 192%
Generic Workers Comp Tx Non Par [9010] $205 192%
Generic Workers Comp Tx Par [8002] $205 192%
Generic Workers Comp Tx Par [9011] $205 192%
Sana Benefits [3069] $205 192%
Velocity [3070] $205 192%
Health Plans Inc [5017] $257 241%
Medical Cost Containment Professionals [3059] $257 241%
Dart Member Care [3039] $277 259%
Healthscope Benefits [2052] $277 259%
Healthscope Benefits [3063] $277 259%
Medicaid / KanCare $429 402%
Friday Health Plan [2061] $500 468%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3500 W Wheatland Road, Dallas, TX 75237
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals