CMS Price Transparency Data

CT scan, pelvis

Facility: Intermountain Health Delta Community Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $2,310
  • Cash Discount Price: $1,824
  • vs. Medicare Baseline: 21.63x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Intermountain Health Delta Community Hospital is $2,310. 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 21.63x the Medicare baseline. Located in 126 South White Sage Avenue, Delta, UT.
Cash / Self-Pay
$1,824

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,310

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: $2,310 (2163%)
Cash: $1,824 (1708% of Medicare)
Ins. Median: $2,310 (2163% 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 2163% of the Medicare baseline (a markup of 2063%). 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
Aetna $51 - $2,334 48%
American Health $51 - $778 48%
Blue Cross Blue Shield $51 - $2,310 48%
Health Partners Of Nevada $51 - $778 48%
Health Plan Of Nevada $51 - $2,164 48%
Healthy U $51 - $2,164 48%
Humana $51 - $778 48%
Molina $51 - $2,310 48%
Selecthealth $51 - $2,310 48%
UnitedHealthcare $51 - $2,310 48%
Awh Connected $533 - $2,334 499%
Byu Athletics $533 - $2,310 499%
Campbell Scientific $533 - $2,310 499%
Cigna $533 - $2,310 499%
Deseret Mutual $533 - $2,310 499%
Emi $533 - $2,310 499%
Emi Health $533 - $2,310 499%
Franklin County $533 - $2,310 499%
Health Utah $533 - $2,310 499%
Ifit $533 - $2,310 499%
Juniper Systems $533 - $2,310 499%
Lw Miller $533 - $2,310 499%
Managed Care Admin $533 - $2,310 499%
Motivhealth $533 - $2,310 499%
Pehp $533 - $2,310 499%
Prodegi Corp Benefit $533 - $2,310 499%
Tanner Llc $533 - $2,310 499%
Utah Tech $533 - $2,310 499%
Wise Network $533 - $2,310 499%
Triwest $926 867%
Injury Care Of Nevada $1,824 1708%
Byu Risk Management $2,067 1935%
Corporation Of The President $2,067 1935%
Corvel Corporation $2,067 1935%
Wcf Insurance $2,067 1935%
Global Excel $2,310 2163%
Hygeia Corporation $2,310 2163%
Medcare International $2,310 2163%
Springtide $2,310 2163%
Uofu $2,310 2163%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 126 South White Sage Avenue, Delta, UT 84624
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals