CMS Price Transparency Data
CT scan, pelvis
Facility: Children's Hosp of Los Angeles
Billing Code: 72192 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72192
- Insurance Median: $596
- Cash Discount Price: $917
- vs. Medicare Baseline: 5.58x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Children's Hosp of Los Angeles is $596. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $917. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.58x the Medicare baseline. Located in 4650 Sunset Blvd, Ms 108, Los Angeles, CA.
Cash / Self-Pay
$917
Average discount available for prompt cash payment at this facility.
Insurance Median
$596
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: $917 (859%)
Insurance Median: $596 (558%)
Cash: $917 (859% of Medicare)
Ins. Median: $596 (558% 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 558% of the Medicare baseline (a markup of 458%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Champus | $130 | 122% |
| Medicare (plans) | $132 - $148 | 124% |
| UnitedHealthcare | $134 - $714 | 125% |
| Molina | $137 - $704 | 128% |
| Medi-Cal | $137 - $334 | 128% |
| Inland Empire Health Plan | $137 - $688 | 128% |
| Caloptima | $179 - $916 | 168% |
| Adventist Health Physicians | $242 - $916 | 227% |
| St Francis Medical Center | $265 - $1,175 | 248% |
| Altamed | $265 - $916 | 248% |
| Shriners Hospital | $275 | 257% |
| Medicaid / KanCare | $275 - $916 | 257% |
| Intl - Global Excel Management | $301 - $596 | 282% |
| Culinary Health Fund | $301 - $504 | 282% |
| Serra Community Med Clinic | $314 - $916 | 294% |
| Intl - Quality Health Management | $324 - $596 | 303% |
| Intl - Aixin Life Insurance Co | $324 - $596 | 303% |
| Point Comfort Underwriters | $334 | 313% |
| Community Family Care IPA | $334 - $916 | 313% |
| Valley Presbyterian Hospital | $334 - $916 | 313% |
| Beech Street | $367 | 344% |
| Non-Contract Payors | $367 | 344% |
| Incentive Health Network | $367 | 344% |
| La Care | $367 - $916 | 344% |
| Health Net | $382 - $1,146 | 358% |
| Cigna | $403 - $1,952 | 377% |
| Applecare Medical Group | $411 - $1,710 | 385% |
| Emanate Health Medical Center Mmc | $412 | 386% |
| Choc Health Alliance | $417 | 390% |
| Kaiser | $427 - $522 | 400% |
| Axminster Medical Group | $440 - $678 | 412% |
| Facey Medical Group | $440 - $678 | 412% |
| St. John's Health Clinic | $440 - $678 | 412% |
| Accarent Health | $458 | 429% |
| Managed Care Systems | $458 - $1,963 | 429% |
| Sansum Clinic | $458 | 429% |
| Staywell Insurance | $458 | 429% |
| Pioneer Prov Ntwk | $458 | 429% |
| Mercy Care | $458 | 429% |
| Citrus Valley Phys Grp | $458 - $1,800 | 429% |
| Gemcare IPA | $458 - $1,936 | 429% |
| Aetna | $476 - $504 | 446% |
| Book Md | $477 - $1,603 | 447% |
| Good Samaritan Medical Group | $486 - $2,356 | 455% |
| Bella Vista Med Grp | $487 - $916 | 456% |
| Global Care Medical Group | $487 - $916 | 456% |
| El Proyecto Del Barrio | $487 - $916 | 456% |
| Health Care La IPA | $487 - $916 | 456% |
| Watts Healthcare Mmc | $487 - $916 | 456% |
| Centinela Valley IPA | $487 - $916 | 456% |
| Premier Physicians Ntwk | $487 - $916 | 456% |
| Access Medical Group | $495 - $541 | 463% |
| Blue Shield | $495 - $916 | 463% |
| Hollywood Presbyterian Medical Center | $501 - $916 | 469% |
| National Healthcare Solutions | $504 | 472% |
| Choice Medical Group | $504 | 472% |
| Community Care | $504 | 472% |
| Intl - Global Medical Management | $504 | 472% |
| Blue Cross Blue Shield | $533 - $916 | 499% |
| Heritage Provider Network | $534 - $1,936 | 500% |
| Seoul Medical Group | $541 - $546 | 507% |
| Serendib Healthways Mmc | $541 - $916 | 507% |
| Preferred IPA - Commercial | $550 | 515% |
| Delta Health Systems | $550 | 515% |
| Los Angeles Medical Center IPA | $550 - $916 | 515% |
| Private Hlthcare System | $550 | 515% |
| Allied Pacific IPA | $550 - $916 | 515% |
| Emanate Health Medical Center Commercial | $550 | 515% |
| Ventura County Health Plan | $550 - $2,586 | 515% |
| Self-Pay | $550 | 515% |
| Family Care Specialists | $550 - $916 | 515% |
| Bright Medical Associates | $550 | 515% |
| Sanus Health | $550 | 515% |
| Alhambra Hospital Medical Center | $550 - $916 | 515% |
| Sierra Health and Life Insurance Company | $574 | 537% |
| Care 1St | $584 - $916 | 547% |
| White Memorial Medical Center | $584 - $916 | 547% |
| Redlands Community Hospital | $596 | 558% |
| Calvo Selectcare | $596 | 558% |
| Embassy - Saudi Arabia | $596 | 558% |
| Cedar Sinai Med Grp | $596 | 558% |
| Plotkin Health | $596 | 558% |
| Marian Health Services | $596 | 558% |
| Intl - Concierge Healthcare Services | $596 | 558% |
| Axis Services International | $596 | 558% |
| Intl - Erv Travel Services | $596 - $642 | 558% |
| Serra Community Med Clinic - Commercial | $596 | 558% |
| Seaside Health Plan | $596 - $916 | 558% |
| Prime Health Services | $596 | 558% |
| Intl - Msh China Enterprise Services | $596 | 558% |
| Lakewood Health Plan | $596 | 558% |
| Star Healthcare Network Commercial | $596 | 558% |
| Karing Physicians Medical Group | $598 - $916 | 560% |
| Noble Community Medical Associates | $598 - $916 | 560% |
| Regent Medical Group | $598 - $916 | 560% |
| Avalon IPA | $601 - $916 | 563% |
| Primary Care and Pediatric IPA | $601 - $916 | 563% |
| Mabuhay Medical Group | $601 - $916 | 563% |
| Exceptional Care Medical Group | $601 - $1,791 | 563% |
| Cal Care IPA | $608 - $916 | 569% |
| Hispanic Physician IPA | $618 - $916 | 579% |
| Gold Coast Health Plan | $618 - $916 | 579% |
| Associated Hispanic Physicians IPA | $618 - $916 | 579% |
| Beverly Hospital | $621 - $916 | 581% |
| Pacific Alliance Medical Center | $621 - $916 | 581% |
| Preferred IPA | $621 - $916 | 581% |
| San Judas Med Grp | $624 - $916 | 584% |
| Family Health Alliance Med Grp | $631 - $916 | 591% |
| Accountable Health | $638 - $916 | 597% |
| Souther California Hosp System - Mmc | $640 - $916 | 599% |
| Beaver Medical Group | $642 | 601% |
| Memorialcare Med Foundation | $642 | 601% |
| Primecare Medical Network | $642 | 601% |
| Korean American Med Grp | $642 | 601% |
| Multiplan | $642 | 601% |
| Angeles IPA | $642 - $916 | 601% |
| Cencal Health | $644 - $916 | 603% |
| Crown City Medical Group | $668 - $916 | 625% |
| Employee Health Systems Med Grp | $668 - $916 | 625% |
| Imperial Health Holdings Medical Group | $681 - $916 | 638% |
| Prospect Medical Group | $687 | 643% |
| Embassy - Kuwait | $687 | 643% |
| Interlink Health Services | $687 | 643% |
| Healthy New Life Medical Corp | $698 - $916 | 653% |
| Asian Community Medical Group | $698 - $916 | 653% |
| California Pacific Physicians Medical Group | $698 - $916 | 653% |
| Embassy - All Others | $733 | 686% |
| Self-Pay International | $733 | 686% |
| Community Care IPA Mmc | $738 - $916 | 691% |
| Dignity Health | $741 - $916 | 694% |
| Southern Atlantic Medical Group Mmc | $780 - $916 | 730% |
| Providence Health Network | $790 - $1,530 | 740% |
| Superior Choice Medical Group | $818 - $916 | 766% |
| Kern Family Health Plan | $821 - $916 | 769% |
| Southland San Gabriel Valley Medical Group | $821 - $916 | 769% |