CMS Price Transparency Data

CT scan, pelvis

Facility: St Francis Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $2,212
Cash Discount Price: $1,986
vs. Medicare Baseline: 20.71x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at St Francis Hospital is $2,212. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,986. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.71x the Medicare baseline. Located in 1215 Franciscan Dr, Litchfield, IL.

Cash / Self-Pay

$1,986

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,212

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: $1,986 (1859%)

Insurance Median: $2,212 (2071%)

Cash: $1,986 (1859% of Medicare)

Ins. Median: $2,212 (2071% 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 2071% of the Medicare baseline (a markup of 1971%). 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
Wexford	$132	124%
Molina Healthcare	$139 - $608	130%
Meridian Health Plan	$146	137%
Clear Spring Health of Illinois	$579	542%
Humana	$579	542%
Blue Cross Blue Shield	$579 - $634	542%
Aetna	$607 - $1,939	568%
UnitedHealthcare	$607 - $2,758	568%
Amish Community	$772	723%
Celtic Insurance Company	$1,396	1307%
Claim Doc	$1,448	1356%
Hopetrust	$1,586	1485%
Wellfirst	$1,774	1661%
First Health	$2,046	1916%
Caterpillar, Inc.	$2,212	2071%
Cigna	$2,290	2144%
Current Health Solutions	$2,317	2169%
Consociate Group	$2,344	2195%
Multiplan/Phcs	$2,344	2195%
Healthlink	$2,353	2203%
Healthcare Finest Network (Hfn)	$2,482	2324%
Provider Network of America	$2,482	2324%
Live360	$2,758	2582%
Healthscope	$2,758	2582%
Naphcare	$2,758	2582%
Health Alliance Medical Plans	$2,758	2582%
Interplan	$2,758	2582%
Illinois Breast and Cervical Cancer Program	$2,758	2582%

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 $1,986.
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 St Francis Hospital 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.