CMS Price Transparency Data

CT scan, pelvis

Facility: CHI St Lukes Lakeside Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $507
Cash Discount Price: $1,574
vs. Medicare Baseline: 4.75x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at CHI St Lukes Lakeside Hospital is $507. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,574. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.75x the Medicare baseline. Located in 17400 St Lukes Way, The Woodlands, TX.

Cash / Self-Pay

$1,574

Average discount available for prompt cash payment at this facility.

Insurance Median

$507

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: $1,574 (1474%)

Insurance Median: $507 (475%)

Cash: $1,574 (1474% of Medicare)

Ins. Median: $507 (475% 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 475% of the Medicare baseline (a markup of 375%). 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
Renaissance	$77	72%
Wellpoint	$105 - $160	98%
Blue Cross Blue Shield	$107 - $488	100%
Cigna	$107 - $3,147	100%
Humana	$107 - $2,922	100%
Kelsey	$107	100%
Selectcare	$107	100%
UnitedHealthcare	$107 - $3,715	100%
Aetna	$109 - $3,057	102%
United	$109 - $2,156	102%
Amerivantage	$110	103%
Devoted	$114	107%
Scanhealth	$114	107%
Kindred	$117	110%
Chc	$123 - $2,473	115%
Kelseycare	$144 - $1,155	135%
Ambetter / Centene	$160	150%
Community Health Choice	$160	150%
Harris Health	$160	150%
Bright Health	$182	170%
Nx Health	$346	324%
Tchp	$360 - $482	337%
Tchpchip	$1,574 - $1,978	1474%
Texastruechoice	$2,473	2315%
Coventry	$2,922	2736%
First Health	$2,922	2736%
Healthsmart	$3,147	2946%
Interlink	$3,147	2946%
Multiplan	$3,372	3157%
USA Health Network	$3,822	3578%
Mhealth Network	$4,496	4209%

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 $1,574.
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 CHI St Lukes Lakeside 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.