CMS Price Transparency Data

CT scan, pelvis

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $1,468
Cash Discount Price: $1,488
vs. Medicare Baseline: 13.74x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at University of Wi Hospitals & Clinics Authority is $1,468. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,488. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.74x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.

Cash / Self-Pay

$1,488

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,468

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: $1,488 (1393%)

Insurance Median: $1,468 (1374%)

Cash: $1,488 (1393% of Medicare)

Ins. Median: $1,468 (1374% 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 1374% of the Medicare baseline (a markup of 1274%). 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
Aetna	$107 - $1,989	100%
Blue Cross Blue Shield	$107 - $2,356	100%
Humana	$107	100%
Medicare (plans)	$107 - $109	100%
UnitedHealthcare	$107 - $1,552	100%
Alliance_Premier_Network	$1,185	1109%
Mercycare	$1,230	1152%
Triology	$1,265 - $1,513	1184%
Security_Health_Plan	$1,339 - $1,575	1254%
Employer'S_Coalition_On_Health	$1,364 - $1,910	1277%
Alliance	$1,395	1306%
Hfn	$1,414 - $1,910	1324%
United_Healthcare	$1,421 - $2,106	1330%
Beloit_Health_System	$1,438	1346%
Aspirus_Health_Plan	$1,448	1356%
Cigna	$1,488	1393%
Health_Partners_Insurance	$1,513	1417%
Health_Payment_Systems	$1,520	1423%
Dean_Health_Plan	$1,587	1486%
Medical_Associates	$1,637	1533%
Wps	$1,719 - $1,892	1609%
Employers_Healthcare_Coalition_Of_Wi	$1,736	1625%
Aspirus_Network_Inc	$1,910	1788%
Chorus_Community	$1,984	1858%
Ghc_Eau_Claire_Health_Plan	$1,984	1858%
Multiplan	$1,984 - $2,282	1858%
Sheybogan_Employers_Health_Network	$1,984	1858%
Coventry	$2,108	1974%
Dean_Care	$2,108	1974%
Healthsmart	$2,182	2043%

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 $1,488.
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 University of Wi Hospitals & Clinics Authority 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.