CMS Price Transparency Data

CT scan, pelvis

Facility: The Outer Banks Hospital, Inc

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $2,173
Cash Discount Price: $1,889
vs. Medicare Baseline: 20.34x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at The Outer Banks Hospital, Inc is $2,173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,889. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.34x the Medicare baseline. Located in 4800 South Croatan Highway, Nags Head, NC.

Cash / Self-Pay

$1,889

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,173

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: $1,889 (1769%)

Insurance Median: $2,173 (2034%)

Cash: $1,889 (1769% of Medicare)

Ins. Median: $2,173 (2034% 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 2034% of the Medicare baseline (a markup of 1934%). 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
Blue Cross Blue Shield	$1,046 - $2,069	979%
Carolina Complete Health [1317]	$1,100	1030%
Wellcare [1320]	$1,106	1035%
Amerihealth McAid Adv [1316]	$1,111	1040%
Liberty Advantage [1313]	$1,242	1163%
UnitedHealthcare	$1,272 - $1,981	1191%
Humana	$1,282	1200%
Aetna	$1,311 - $2,642	1227%
Longevity Health [1411]	$1,535	1437%
Nc Dept of Public Safety [1095]	$2,126	1990%
Medcost [1067]	$2,173 - $2,274	2034%
Cigna	$2,868 - $3,205	2685%
Multiplan [1031]	$3,205	3001%

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 $1,889.
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 The Outer Banks Hospital, Inc 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.