CMS Price Transparency Data

CT scan, pelvis

Facility: Carilion Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,019
Cash Discount Price: $700
vs. Medicare Baseline: 9.54x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Carilion Medical Center is $1,019. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $700. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.54x the Medicare baseline. Located in 1906 Belleview Avenue, Se, Roanoke, VA.

Cash / Self-Pay

$700

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,019

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: $700 (655%)

Insurance Median: $1,019 (954%)

Cash: $700 (655% of Medicare)

Ins. Median: $1,019 (954% 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 954% of the Medicare baseline (a markup of 854%). 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
Aetna	$92 - $1,329	86%
Humana	$94 - $128	88%
Blue Cross Blue Shield	$100 - $381	94%
UnitedHealthcare	$101 - $1,636	95%
Sentara Health Plan	$103 - $1,241	96%
Abh Of Va (Formerly Coventry)	$128	120%
Abh Of Wva (Formerly Coventry)	$128	120%
Gateway - Tier 3	$1,101	1031%
Vhn - Ultra	$1,241	1162%
Cigna	$1,349 - $1,441	1263%
Connecticare	$1,401	1312%
Vhn - Plus	$1,541	1443%
Gateway - Tier 2	$1,601	1499%
Vhn	$1,601	1499%
Vhn - Link	$1,801	1686%
Gateway - Tier 1	$1,901	1780%
Vhn - Secondary Payors	$1,901	1780%

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 $700.
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 Carilion Medical Center 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.