CMS Price Transparency Data

CT scan, pelvis

Facility: Springfield Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,660
Cash Discount Price: $1,559
vs. Medicare Baseline: 15.54x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Springfield Hospital is $1,660. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,559. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.54x the Medicare baseline. Located in Po Box 2003, Springfield, VT.

Cash / Self-Pay

$1,559

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,660

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: $1,559 (1460%)

Insurance Median: $1,660 (1554%)

Cash: $1,559 (1460% of Medicare)

Ins. Median: $1,660 (1554% 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 1554% of the Medicare baseline (a markup of 1454%). 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	$790 - $2,078	740%
Mvp Health Plan	$790 - $1,600	740%
UnitedHealthcare	$790 - $1,870	740%
Wellsense	$790 - $2,078	740%
Harvard Pilgrim Health Care	$798 - $1,719	747%
Wellcare	$813	761%
Tufts Health Plan	$1,277	1196%
Cigna	$1,459 - $2,161	1366%
Multiplan	$1,725	1615%
Aetna	$1,974	1848%
Coventry	$1,974	1848%
Beacon Health	$2,078	1946%
Manage Behavioral Health	$2,078	1946%
Martin'S Point Healthcare	$2,078	1946%

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 $1,559.
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 Springfield 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.