CMS Price Transparency Data

CT scan, pelvis

Facility: Memorial Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $354
  • Cash Discount Price: $834
  • vs. Medicare Baseline: 3.31x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Memorial Medical Center is $354. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $834. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.31x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$834

Average discount available for prompt cash payment at this facility.

Insurance Median
$354

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: $834 (781%)
Insurance Median: $354 (331%)
Cash: $834 (781% of Medicare)
Ins. Median: $354 (331% 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 331% of the Medicare baseline (a markup of 231%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Ambetter / Centene $46 - $753 43%
Triwest Va Pccc-All Plans $48 - $615 45%
Amerigroup Mcr Adv-All Other Plans $49 - $627 46%
Care Improvement Plus - All Other Plans $49 - $627 46%
Care Improvement Plus Mcr $49 - $634 46%
Superior Allwell Mcr Adv-All Other Plans $49 - $627 46%
UnitedHealthcare $49 - $1,793 46%
Universal American Mcr-All Other Plans $49 - $627 46%
Universal American Snp $51 - $659 48%
Coventry First Hlth Hmo Ppo-All Other Plans $61 - $1,793 57%
Coventry First Hlth Mcr Adv $61 - $627 57%
Galaxy Health Network-All Plans $71 - $1,905 66%
Capstar Health Network-All Plans $77 - $1,793 72%
Cigna $77 - $1,681 72%
Healthcare Highways-All Plans $93 - $1,793 87%
Prime Healthcare Services-All Plans $100 - $1,569 94%
Blue Cross Blue Shield $107 - $384 100%
Humana $114 - $1,793 107%
Corvel Work Comp-All Plans $121 - $1,905 113%
Independent Med Sys Ppo-All Plans $121 - $1,905 113%
Multiplan Mcr Adv $121 - $627 113%
Multiplan Phcs Ppo-All Other Plans $121 - $1,905 113%
Provider Select Ppo-All Plans $121 - $1,905 113%
Three Rivers Ppo-All Plans $121 - $1,905 113%
Usa Mso - All Plans $121 - $1,905 113%
Amerigroup Chip $143 - $1,076 134%
Amerigroup Star $143 - $1,076 134%
Amerigroup Star Kids $143 - $1,076 134%
Amerigroup Star Plus $143 - $1,076 134%
Comm Health Chip $143 - $1,076 134%
Comm Health Perinatal-All Other Plans $143 - $1,076 134%
Molina Chip/Star-All Plans $143 - $1,076 134%
Scott & White Chip/Star-All Plans $143 - $1,076 134%
Superior Chip/Star $143 - $1,076 134%
Texas Childrens Hp - All Plans $143 - $1,076 134%
Comm Health Mcaid Hmo $150 - $1,129 140%
Comm Health Star $150 - $1,129 140%
Aetna $1,793 1679%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals