CMS Price Transparency Data

CT scan, pelvis

Facility: Texas Orthopedic Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $989
Cash Discount Price: $7,488
vs. Medicare Baseline: 9.26x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Texas Orthopedic Hospital is $989. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,488. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.26x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.

Cash / Self-Pay

$7,488

Average discount available for prompt cash payment at this facility.

Insurance Median

$989

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: $7,488 (7011%)

Insurance Median: $989 (926%)

Cash: $7,488 (7011% of Medicare)

Ins. Median: $989 (926% 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 926% of the Medicare baseline (a markup of 826%). 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	$103	96%
Amerigroup	$105	98%
Texas Childrens Health Plans	$105 - $1,243	98%
Community Health Choice Mcd	$107	100%
United	$109 - $3,369	102%
Aetna	$115 - $1,322	108%
Molina Healthcare	$115	108%
Humana	$131 - $1,602	123%
Blue Cross Blue Shield	$224 - $2,621	210%
Superior Health Plan	$449	420%
Cigna	$1,635 - $2,106	1531%
Texas Workforce Commission	$1,797	1682%
Christus (Usfhp)	$2,995	2804%
Healthsmart Preferred Care	$3,220 - $6,365	3015%
Fidelis Securecare Of Tx	$3,369	3154%
Coventry National First Health	$3,991	3737%
Physicians Cooperative Of Texas	$4,118	3855%
Rockport Workers Comp	$4,118	3855%
Independent Medical System	$4,493	4207%
National Healthcare Solutions	$4,493	4207%
Southwest Medical	$4,493	4207%
Coastal Comp	$4,867	4557%
Multiplan	$5,616 - $6,365	5258%
International Health Insurance	$5,990	5608%
Physicians, Inc	$6,365	5959%
Affiliated Ppo	$6,739	6309%

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 $7,488.
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 Texas Orthopedic Hospital 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.