CMS Price Transparency Data

CT scan, pelvis

Facility: Marshfield Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,054
Cash Discount Price: $1,055
vs. Medicare Baseline: 9.87x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Marshfield Medical Center is $1,054. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,055. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.87x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$1,055

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,054

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: $1,055 (988%)

Insurance Median: $1,054 (987%)

Cash: $1,055 (988% of Medicare)

Ins. Median: $1,054 (987% 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 987% of the Medicare baseline (a markup of 887%). 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
Family Health Center (Fhc)	$556	521%
UnitedHealthcare	$585	548%
Amish/Mennonite	$611	572%
Sanford Health Plan	$611	572%
The Alliance	$772 - $928	723%
Group Health Cooperative Of Eau Claire	$911 - $1,022	853%
Besse Forest Products	$944	884%
Molina Healthcare Of Wi	$944	884%
Rice Lake School District	$944	884%
Wps Health Insurance	$980 - $1,072	918%
Trilogy	$1,000 - $1,067	936%
Medica Of Wi	$1,031 - $1,052	965%
Cigna	$1,044	977%
Healtheos By Multiplan Inc.	$1,044 - $1,055	977%
Corvel	$1,055	988%
First Health	$1,055	988%
Health Partners	$1,055	988%
Three Rivers Provider Network (Trpn)	$1,055	988%
Coventry	$1,067	999%
Health Smart	$1,067	999%
Rising Medical Work Comp	$1,078	1009%
Security Health Plan (Shp)	$1,188 - $1,748	1112%
Blue Cross Blue Shield	$1,609 - $1,838	1506%

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 $1,055.
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 Marshfield Medical Center 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.