CMS Price Transparency Data

CT scan, pelvis

Facility: Medical City Alliance

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $156
Cash Discount Price: $5,735
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Medical City Alliance is $156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,735. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.46x the Medicare baseline. Located in 3101 North Tarrant Parkway, Fort Worth, TX.

Cash / Self-Pay

$5,735

Average discount available for prompt cash payment at this facility.

Insurance Median

$156

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: $5,735 (5369%)

Insurance Median: $156 (146%)

Cash: $5,735 (5369% of Medicare)

Ins. Median: $156 (146% 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.

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
Amerigroup	$105	98%
Cook Childrens Health Plan	$105	98%
Parkland Community Health Plan	$105	98%
United	$105 - $1,302	98%
Cigna	$110 - $803	103%
Aetna	$113 - $4,170	106%
Molina	$115 - $117	108%
Humana	$131 - $367	123%
Blue Cross Blue Shield	$141 - $2,547	132%
Superior Health Plan	$401	375%
Healthcare Highways	$1,939	1815%
Healthsmart Preferred Care	$4,302	4028%
Independent Medical Systems	$5,735	5369%
National Healthcare Solutions	$5,735	5369%

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 $5,735.
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 Medical City Alliance 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.