CMS Price Transparency Data

CT scan, pelvis

Facility: American Fork Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,031
  • Cash Discount Price: $1,824
  • vs. Medicare Baseline: 9.65x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at American Fork Hospital is $1,031. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,824. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.65x the Medicare baseline. Located in 170 North 1100 East, American Fork, UT.
Cash / Self-Pay
$1,824

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,031

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: $1,824 (1708%)
Insurance Median: $1,031 (965%)
Cash: $1,824 (1708% of Medicare)
Ins. Median: $1,031 (965% 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 965% of the Medicare baseline (a markup of 865%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Donor Connect $44 - $588 41%
Aetna $51 - $2,067 48%
American Health $51 - $109 48%
Blue Cross Blue Shield $51 - $1,848 48%
Health Partners Of Nevada $51 - $105 48%
Health Plan Of Nevada $51 - $87 48%
Healthy U $51 - $87 48%
Humana $51 - $110 48%
Molina $51 - $116 48%
Selecthealth $51 - $1,230 48%
UnitedHealthcare $51 - $2,067 48%
Triwest $102 95%
Intermountain Caregiver Plan $300 - $1,172 281%
Awh Connected $533 - $1,568 499%
Byu Athletics $533 - $1,751 499%
Campbell Scientific $533 - $1,751 499%
Deseret Mutual $533 - $1,398 499%
Emi $533 - $1,313 499%
Emi Health $533 - $1,687 499%
Franklin County $533 - $1,751 499%
Ifit $533 - $1,751 499%
Juniper Systems $533 - $1,751 499%
Lw Miller $533 - $1,751 499%
Pehp $533 - $2,164 499%
Tanner Llc $533 - $1,751 499%
Utah Tech $533 - $1,751 499%
Cigna $1,532 - $2,067 1434%
Byu Risk Management $1,702 - $1,775 1593%
Corporation Of The President $1,702 - $1,775 1593%
Wcf Insurance $1,702 - $1,775 1593%
Corvel Corporation $1,751 1639%
Injury Care Of Nevada $1,824 1708%
Managed Care Admin $1,897 1776%
Prodegi Corp Benefit $1,994 1867%
Uofu $1,994 1867%
Springtide $2,018 1889%
Global Excel $2,067 1935%
Medcare International $2,067 1935%
Motivhealth $2,067 1935%
Wise Network $2,067 1935%
Hygeia Corporation $2,188 2048%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 170 North 1100 East, American Fork, UT 84003
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals