CMS Price Transparency Data

CT scan, pelvis

Facility: Lewisgale Hospital Montgomery

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $2,807
Cash Discount Price: $4,291
vs. Medicare Baseline: 26.28x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Lewisgale Hospital Montgomery is $2,807. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,291. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 26.28x the Medicare baseline. Located in 3700 South Main Street, Blacksburg, VA.

Cash / Self-Pay

$4,291

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,807

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: $4,291 (4017%)

Insurance Median: $2,807 (2628%)

Cash: $4,291 (4017% of Medicare)

Ins. Median: $2,807 (2628% 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 2628% of the Medicare baseline (a markup of 2528%). 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	$210 - $640	197%
United	$245 - $1,931	229%
Cigna	$747	699%
Lifeworks	$815	763%
Universal Healthcare Group	$944	884%
Virginia Health Network	$1,502 - $3,047	1406%
Greenvbrier Sporting Club	$2,575	2411%
Aetna	$2,807 - $4,356	2628%
Corvel	$3,090	2893%
Richfield Nursing Center	$3,218	3013%
Richfield Retirement Community	$3,218	3013%
Multiplan	$3,304	3093%
Community Care Network	$3,433	3214%
Graham-White Manufacturing	$3,433	3214%
Occunet Workers Comp	$3,433	3214%
One Health Plan	$3,433	3214%
Phcs	$3,647	3414%
Patients Choice	$3,776	3535%
4Most	$3,862	3616%
American Postal Workers Union	$3,862	3616%
Star Transportation	$3,862	3616%

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 $4,291.
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 Lewisgale Hospital Montgomery 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.