CMS Price Transparency Data

CT scan, pelvis

Facility: St Josephs Community Hospital West Bend

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,762
  • Cash Discount Price: $1,539
  • vs. Medicare Baseline: 16.50x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at St Josephs Community Hospital West Bend is $1,762. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,539. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.50x the Medicare baseline. Located in 3200 Pleasant Valley Road, West Bend, WI.
Cash / Self-Pay
$1,539

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,762

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: $1,539 (1441%)
Insurance Median: $1,762 (1650%)
Cash: $1,539 (1441% of Medicare)
Ins. Median: $1,762 (1650% 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 1650% of the Medicare baseline (a markup of 1550%). 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
Allwell $103 96%
Blue Cross Blue Shield $103 - $2,378 96%
Community Care $103 96%
Health Partners $103 - $1,819 96%
Humana $103 96%
Icare $103 96%
Molina $103 96%
Network Health Plan $103 - $1,033 96%
Security Health Plan Secure Savers $103 96%
UnitedHealthcare $103 - $1,565 96%
Aetna $105 - $1,959 98%
Care Wisconsin $106 99%
Centivo $839 - $923 786%
Froedtert South $1,175 1100%
Chorus Community Health Plan $1,203 1126%
Common Ground $1,679 1572%
Health Payment Systems $1,762 - $2,262 1650%
Sheboygan Employers Health Network $1,791 1677%
Wisconsin Physician Services $2,238 2095%
Trilogy $2,294 2148%
Americas Choice $2,434 2279%
Healtheos $2,434 2279%
Multiplan/Private Healthcare Systems $2,434 2279%
First Health Network $2,462 2305%
Hfn $2,518 2357%
Ibsi Passport $2,518 2357%
Cigna $2,658 2489%
Healthsmart $2,658 2489%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3200 Pleasant Valley Road, West Bend, WI 53095
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals