CMS Price Transparency Data

CT scan, pelvis

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,692
Cash Discount Price: $1,891
vs. Medicare Baseline: 15.84x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $1,692. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,891. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.84x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$1,891

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,692

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: $1,891 (1770%)

Insurance Median: $1,692 (1584%)

Cash: $1,891 (1770% of Medicare)

Ins. Median: $1,692 (1584% 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 1584% of the Medicare baseline (a markup of 1484%). 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
Wps Health Insurance	$400 - $1,339	374%
UnitedHealthcare	$588	551%
The Alliance	$1,011	947%
Security Health Plan (Shp)	$1,034 - $1,149	968%
Amish/Mennonite	$1,094	1024%
Quartz	$1,134	1062%
Cigna	$1,353 - $1,473	1267%
Health Payment Systems	$1,385	1297%
Humana	$1,572 - $1,771	1472%
Group Health Cooperative Of Eau Claire	$1,632 - $1,890	1528%
Network Health Plan	$1,662	1556%
First Health	$1,692	1584%
Molina Healthcare Of Wi	$1,692	1584%
Trilogy	$1,791	1677%
Healtheos By Multiplan Inc.	$1,851 - $1,890	1733%
Health Partners	$1,890	1769%
Coventry	$1,910	1788%
Blue Cross Blue Shield	$3,449 - $5,836	3229%

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 $1,891.
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 - Beaver Dam (Mmc-Bd) 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.