CMS Price Transparency Data

CT scan, pelvis

Facility: Baylor Scott & White Medical Center - Marble Falls

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,236
Cash Discount Price: $1,348
vs. Medicare Baseline: 11.57x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Baylor Scott & White Medical Center - Marble Falls is $1,236. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,348. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.57x the Medicare baseline. Located in 810 W Highway 71, Marble Falls, TX.

Cash / Self-Pay

$1,348

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,236

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: $1,348 (1262%)

Insurance Median: $1,236 (1157%)

Cash: $1,348 (1262% of Medicare)

Ins. Median: $1,236 (1157% 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 1157% of the Medicare baseline (a markup of 1057%). 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
Baylor Scott & White Health Plan	$92 - $1,586	86%
Humana	$97 - $1,573	91%
Superior Health Plan	$97 - $107	91%
Triwest	$97	91%
American Health Plan	$102	95%
Blue Cross Blue Shield	$102 - $536	95%
Corvel	$102	95%
Healthspring	$102	95%
Prime Health Services	$102	95%
Procare Advantage	$102	95%
UnitedHealthcare	$111 - $1,550	104%
Sedgwick	$145	136%
Aetna	$1,236	1157%
Midcoast	$1,236	1157%
Quiktrip	$1,236	1157%
Independent Medical System	$1,348	1262%
Curative	$1,461	1368%
Cigna	$1,466 - $1,725	1373%
First Health	$1,573	1473%
Healthsmart	$1,573 - $1,686	1473%
Bluebell Creameries	$1,686	1579%
Private Health Care System	$1,686	1579%
University Of Mary Hardin-Baylor	$1,725	1615%
Three Rivers	$2,023	1894%

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 $1,348.
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 Baylor Scott & White Medical Center - Marble Falls 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.