CMS Price Transparency Data

CT scan, pelvis

Facility: Thedacare Medical Center - Berlin Inc

Billing Code: 72192 (CPT)

The BaseRate · fair price low confidence
A fair price for this
$367
about 3.4× the $107 Medicare rate · typically $109–$1,457
modeled estimate · not a bill or quote
Medicare pays $107 Fair price $367 Cash price $691 Hospital's list price $1,233

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $789 - $1,853 739%
Blue Cross Blue Shieldmajor $1,615 - $1,732 1512%
Aetnamajor $950 889%
Humanamajor $777 727%
HealthPartners $778 728%
Government programs also on file: Medicare.

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 225 Memorial Drive, Berlin, WI 54923
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals