CMS Price Transparency Data

CT scan, pelvis

Facility: St Joseph's Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,857
  • Cash Discount Price: $2,088
  • vs. Medicare Baseline: 17.39x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at St Joseph's Hospital is $1,857. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,088. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 17.39x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$2,088

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,857

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: $2,088 (1955%)
Insurance Median: $1,857 (1739%)
Cash: $2,088 (1955% of Medicare)
Ins. Median: $1,857 (1739% 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 1739% of the Medicare baseline (a markup of 1639%). 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
Molina Healthcare $215 - $580 201%
Meridian Health Plan $226 212%
Blue Cross Blue Shield $580 543%
Humana $580 543%
Aetna $580 - $2,027 543%
Sae Hospice $580 543%
Clear Spring Health of Illinois $580 543%
UnitedHealthcare $580 - $2,900 543%
Amish Community $812 760%
Cigna $1,190 1114%
Naphcare $1,218 1140%
Celtic Insurance Company $1,276 1195%
Caterpillar, Inc. $1,315 1231%
Hopetrust $1,450 1358%
Claim Doc $1,450 1358%
Wellfirst $1,857 1739%
First Health $2,143 2006%
Healthlink $2,465 2308%
Multiplan/Phcs $2,465 2308%
Provider Network of America $2,610 2444%
Healthcare Finest Network (Hfn) $2,610 2444%
Consociate Group $2,900 2715%
Healthscope $2,900 2715%
Interplan $2,900 2715%
Qtc Medical Group of Illinois $2,900 2715%
Health Alliance Medical Plans $2,900 2715%
Illinois Breast and Cervical Cancer Program $2,900 2715%
Mental Health Network $2,900 2715%
Current Health Solutions $2,900 2715%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals