CMS Price Transparency Data

CT scan, pelvis

Facility: Texas Childrens Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $2,125
Cash Discount Price: $2,260
vs. Medicare Baseline: 19.90x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Texas Childrens Hospital is $2,125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,260. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 19.90x the Medicare baseline. Located in 6621 Fannin Street, Houston, TX.

Cash / Self-Pay

$2,260

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,125

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: $2,260 (2116%)

Insurance Median: $2,125 (1990%)

Cash: $2,260 (2116% of Medicare)

Ins. Median: $2,125 (1990% 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 1990% of the Medicare baseline (a markup of 1890%). 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
Superior Chip	$105 - $110	98%
Driscoll Children'S Health Plan Mcd	$115	108%
First Care Health Plan	$911 - $2,159	853%
UnitedHealthcare	$911 - $2,159	853%
Molina Mcd	$1,012	947%
Blue Cross Blue Shield	$1,181 - $2,125	1106%
Community Health Choice	$1,191 - $2,159	1115%
Community First Health Plan Mcd	$1,349	1263%
Cook Children'S Health Plan	$1,349	1263%
Cigna	$1,923 - $2,159	1800%
Aetna	$2,159	2021%
Kelseycare	$2,192	2052%
Healthsmart	$2,361	2210%
Evolutions Healthcare	$2,530	2369%
First Health	$2,968 - $3,204	2779%
Multiplan	$3,036	2842%
Galaxy Health Network	$3,204	3000%

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 $2,260.
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 Childrens 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.