CMS Price Transparency Data

CT scan, pelvis

Facility: East Adams Rural Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,426
  • Cash Discount Price: $1,202
  • vs. Medicare Baseline: 13.35x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at East Adams Rural Hospital is $1,426. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,202. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.35x the Medicare baseline. Located in 903 South Adams, Ritzville, WA.
Cash / Self-Pay
$1,202

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,426

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: $1,202 (1125%)
Insurance Median: $1,426 (1335%)
Cash: $1,202 (1125% of Medicare)
Ins. Median: $1,426 (1335% 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 1335% of the Medicare baseline (a markup of 1235%). 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
Aetna $1,250 - $1,442 1170%
Molina Mcaid $1,336 1251%
Ambetter / Centene $1,363 1276%
Coordinated Care Mcaid $1,363 1276%
Amerigroup Mcaid-All Plans $1,403 1314%
Premera First-All Plans $1,410 1320%
Assured Hospice Mcr-All Plans $1,426 1335%
Asuris Nw Hlth Mcr Adv $1,426 1335%
Molina Markeplace-All Other Plans $1,426 1335%
Molina Mcr Adv $1,426 1335%
Triwest Va-All Plans $1,426 1335%
UnitedHealthcare $1,442 1350%
Asuris Indiv And Family $1,522 1425%
Asuris Nw Health-All Other Plans $1,522 1425%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 903 South Adams, Ritzville, WA 99169
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals