CMS Price Transparency Data

CT scan, pelvis

Facility: Cook Childrens Medical Center Prosper

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,098
Cash Discount Price: $2,226
vs. Medicare Baseline: 10.28x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Cook Childrens Medical Center Prosper is $1,098. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,226. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.28x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$2,226

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,098

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: $2,226 (2084%)

Insurance Median: $1,098 (1028%)

Cash: $2,226 (2084% of Medicare)

Ins. Median: $1,098 (1028% 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 1028% of the Medicare baseline (a markup of 928%). 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
Aetna	$126 - $2,523	118%
Beacon	$135 - $1,603	126%
El Paso Health First	$135 - $1,603	126%
Health Plan W. Uhrip	$135	126%
Health Plan W/O Uhrip	$135 - $1,603	126%
Tx Children Health	$135 - $1,603	126%
Wellpoint	$141	132%
Blue Cross Blue Shield	$145 - $2,672	136%
Superior Health	$145	136%
Firstcare	$148 - $2,375	139%
United Community	$148 - $1,098	139%
UnitedHealthcare	$1,306 - $2,523	1223%
S&W Health	$2,493	2334%
Cigna	$2,523	2362%
Healthscope	$2,523	2362%
Imagine Health	$2,523	2362%
Humana	$2,582 - $2,612	2417%
Multiplan	$2,582	2417%
First Health	$2,612	2445%
Galaxy Health	$2,672	2502%
Healthsmart	$2,672	2502%
Usamco	$2,731	2557%

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 $2,226.
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 Cook Childrens Medical Center Prosper 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.