CMS Price Transparency Data

CT scan, pelvis

Facility: Reston Hospital Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,317
Cash Discount Price: $4,304
vs. Medicare Baseline: 12.33x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Reston Hospital Center is $1,317. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,304. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.33x the Medicare baseline. Located in 1850 Town Center Parkway, Reston, VA.

Cash / Self-Pay

$4,304

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,317

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: $4,304 (4030%)

Insurance Median: $1,317 (1233%)

Cash: $4,304 (4030% of Medicare)

Ins. Median: $1,317 (1233% 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 1233% of the Medicare baseline (a markup of 1133%). 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
Blue Cross Blue Shield	$189 - $563	177%
United	$245 - $1,955	229%
Lifeworks	$810 - $825	758%
Cigna	$844 - $1,464	790%
Universal Healthcare Group	$938 - $956	878%
Carefirst	$1,317	1233%
Aetna	$1,819	1703%
Greenvbrier Sporting Club	$2,559 - $2,606	2396%
Virginia Health Network	$3,028 - $3,084	2835%
Corvel	$3,071 - $3,127	2875%
Occunet Workers Comp	$3,412 - $3,475	3194%
4Most Health Network	$3,838 - $3,909	3593%

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 $4,304.
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 Reston Hospital 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.