CMS Price Transparency Data

CT scan, pelvis

Facility: Lonesome Pine Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $142
Cash Discount Price: $588
vs. Medicare Baseline: 1.33x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Lonesome Pine Hospital is $142. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $588. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.33x the Medicare baseline. Located in 1990 Holton Avenue East, Big Stone Gap, VA.

Cash / Self-Pay

$588

Average discount available for prompt cash payment at this facility.

Insurance Median

$142

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: $588 (551%)

Insurance Median: $142 (133%)

Cash: $588 (551% of Medicare)

Ins. Median: $142 (133% 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.

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
UnitedHealthcare	$96 - $3,026	90%
Aetna	$102 - $1,673	95%
Amerigroup	$102	95%
Humana	$102	95%
Managed Medicaire	$102	95%
Medicare (plans)	$102	95%
Sentara Health	$102 - $992	95%
United Mine Workers Of America	$102	95%
Blue Cross Blue Shield	$105 - $3,918	98%
Cigna	$107 - $642	100%
Devoted Health Plan	$107	100%
Molina Healthcare	$107 - $142	100%
Mountain Empire Pace	$107	100%
Nhc Advantage	$107	100%
Wellcare	$108	101%
Optima Health	$140	131%
Ambetter / Centene	$222	208%
Seven Corners, Inc.	$245	229%
Medcost	$1,865	1746%
First Health Coventry	$3,526	3301%

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 $588.
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 Lonesome Pine Hospital 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.