CMS Price Transparency Data

CT scan, pelvis

Facility: Spotsylvania Regional Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,193
  • Cash Discount Price: $3,868
  • vs. Medicare Baseline: 11.17x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Spotsylvania Regional Medical Center is $1,193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,868. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.17x the Medicare baseline. Located in 4600 Spotsylvania Parkway, Fredericksburg, VA.
Cash / Self-Pay
$3,868

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,193

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: $3,868 (3621%)
Insurance Median: $1,193 (1117%)
Cash: $3,868 (3621% of Medicare)
Ins. Median: $1,193 (1117% 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 1117% of the Medicare baseline (a markup of 1017%). 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
Blue Cross Blue Shield $128 - $483 120%
United $245 - $1,740 229%
Lifeworks $735 688%
Cigna $1,029 - $1,303 963%
Virginia Health Network $1,354 - $2,514 1268%
Aetna $1,819 1703%
Kaiser $2,282 2137%
Greenvbrier Sporting Club $2,321 2173%
Multiplan $2,746 2571%
Corvel $2,785 2607%
Occunet Workers Comp $3,094 2897%
4Most Health Nework $3,481 3259%
Three Rivers Provider Network $3,481 3259%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4600 Spotsylvania Parkway, Fredericksburg, VA 22408
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals