CMS Price Transparency Data

CT scan, pelvis

Facility: Dickenson Community Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $752
  • Cash Discount Price: $577
  • vs. Medicare Baseline: 7.04x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Dickenson Community Hospital is $752. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $577. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.04x the Medicare baseline. Located in 312 Hospital Drive, Clintwood, VA.
Cash / Self-Pay
$577

Average discount available for prompt cash payment at this facility.

Insurance Median
$752

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: $577 (540%)
Insurance Median: $752 (704%)
Cash: $577 (540% of Medicare)
Ins. Median: $752 (704% 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 704% of the Medicare baseline (a markup of 604%). 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
UnitedHealthcare $173 - $2,507 162%
Optima Health $194 182%
Blue Cross Blue Shield $199 - $752 186%
Aetna $201 - $2,006 188%
Molina Healthcare $201 - $782 188%
Cigna $427 - $790 400%
Amerigroup $752 704%
Managed Medicaire $752 704%
Medicare (plans) $752 704%
Sentara Health $752 - $925 704%
United Mine Workers Of America $752 704%
Humana $764 715%
Devoted Health Plan $790 740%
Nhc Advantage $790 740%
Medcost $877 821%
Ambetter / Centene $928 869%
Seven Corners, Inc. $2,507 2347%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 312 Hospital Drive, Clintwood, VA 24228
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals