CMS Price Transparency Data

CT scan, pelvis

Facility: Regional Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $870
  • Cash Discount Price: $1,249
  • vs. Medicare Baseline: 8.15x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Regional Medical Center is $870. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,249. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.15x the Medicare baseline. Located in 709 W Main Street, Manchester, IA.
Cash / Self-Pay
$1,249

Average discount available for prompt cash payment at this facility.

Insurance Median
$870

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: $1,249 (1169%)
Insurance Median: $870 (815%)
Cash: $1,249 (1169% of Medicare)
Ins. Median: $870 (815% 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 815% of the Medicare baseline (a markup of 715%). 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
Medical Associates Health Plan - Tri $870 815%

Consumer Guidance & Cost Commentary

Regional Medical Center in Manchester, Iowa, offers a CT scan of the pelvis (CPT 72192) with a cash median price of $1,249 and a negotiated rate of $870 through Medical Associates Health Plan - Tri. While the facility is a government-owned Critical Access Hospital with a high rating of 4, the cash price remains significantly higher than the median paid amount of $579. For patients with high-deductible plans, paying the cash rate of $1,249 upfront may be more cost-effective than relying on insurance, which could result in a higher out-of-pocket expense depending on the specific plan structure.

To ensure you receive the best possible rate, it is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50%. Additionally, if you have insurance, remember that commercial negotiated rates often include administrative overhead, making the cash price a viable alternative if your deductible has not yet been met. Always request an itemized bill to verify that all charges are accurate and to identify any potential errors before finalizing payment.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 709 W Main Street, Manchester, IA 52057
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals