CMS Price Transparency Data

CT scan, pelvis

Facility: Astria Sunnyside Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,566
Cash Discount Price: $1,817
vs. Medicare Baseline: 14.66x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Astria Sunnyside Hospital is $1,566. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,817. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 14.66x the Medicare baseline. Located in 1016 Tacoma Avenue, Sunnyside, WA.

Cash / Self-Pay

$1,817

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,566

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: $1,817 (1701%)

Insurance Median: $1,566 (1466%)

Cash: $1,817 (1701% of Medicare)

Ins. Median: $1,566 (1466% 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 1466% of the Medicare baseline (a markup of 1366%). 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
Medicare (plans)	$161 - $841	151%
Medicaid / KanCare	$582 - $1,020	545%
Aetna	$747 - $2,929	699%
Healthcomp_Ihs	$747 - $816	699%
Humana	$747 - $2,995	699%
Molina	$747 - $816	699%
Va	$747 - $816	699%
Tricare	$754 - $824	706%
Regence	$1,566 - $1,711	1466%
Cigna	$1,828 - $1,997	1711%
Li	$1,870 - $2,043	1751%
First_Choice	$2,284 - $2,496	2138%
Tpsc	$2,376 - $2,596	2225%
Kaiser	$2,392 - $2,613	2239%
Premera	$2,479 - $2,709	2321%
UnitedHealthcare	$2,589 - $2,829	2424%
Fhpw	$2,680 - $2,929	2509%
Healthcomp	$2,741 - $2,995	2566%
Bcchp	$3,046 - $3,328	2852%
Great_Rivers	$3,046 - $3,328	2852%
Zenith	$3,046 - $3,328	2852%

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 $1,817.
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 Astria Sunnyside 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.