CMS Price Transparency Data

CT scan, pelvis

Facility: Mercy Hospital of Buffalo

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $102
  • Cash Discount Price: $268
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Mercy Hospital of Buffalo is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $268. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.95x the Medicare baseline. Located in 565 Abbott Road, Buffalo, NY.
Cash / Self-Pay
$268

Average discount available for prompt cash payment at this facility.

Insurance Median
$102

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: $268 (251%)
Insurance Median: $102 (95%)
Cash: $268 (251% of Medicare)
Ins. Median: $102 (95% 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.

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
UnitedHealthcare $35 - $173 33%
Medicaid / KanCare $41 - $157 38%
Univera Healthcare Essential [100170] $42 - $170 39%
VA Veterans Affairs [700001] $42 - $131 39%
Univera Healthcare [100169] $43 - $161 40%
Independent Health Essential [100166] $44 - $157 41%
Fidelis Essential [100163] $45 - $318 42%
Crime Victims [100176] $45 - $157 42%
Tuscarora Nation [550120] $45 - $157 42%
Vna Option Mltc [350110] $45 - $157 42%
Amerigroup [350102] $45 - $204 42%
Blue Cross Blue Shield $45 - $318 42%
Excellus Rochester McD [350117] $45 - $157 42%
Beacon Essential [350122] $45 - $157 42%
Ghi [100153] $47 - $124 44%
Medicare (plans) $49 - $188 46%
Humana $50 - $137 47%
Aetna $50 - $137 47%
Hospice [550001] $50 - $131 47%
Catholic Health Life Pace [400005] $50 - $131 47%
Meritain [100063] $50 - $131 47%
Champ VA [700002] $50 - $131 47%
Cigna $50 - $189 47%
Fallon Health [450115] $50 - $131 47%
Seneca Nation [450119] $50 - $131 47%
Covid19 Hrsa [45013] $50 - $131 47%
Magnacare [100142] $50 - $131 47%
Tricare $50 - $131 47%
Wellcare Fidelis Dual [450451] $51 - $137 48%
Fidelis Dual Advantage [450120] $51 - $137 48%
Independent Health [100165] $54 - $312 51%
Iha First Choice [800001] $54 - $314 51%
Wellcare [450129] $55 - $144 51%
UPMC Health Plan [100181] $58 - $285 54%
Fidelis Exchange [100164] $60 - $157 56%
Beacon Health Options [100023] $60 - $157 56%
Mvp Healthcare [100168] $68 - $176 64%
Molina Essential [100167] $102 - $354 95%
No Fault [114001] $108 - $430 101%
Federal Workers Compensation [500100] $108 - $430 101%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 565 Abbott Road, Buffalo, NY 14220
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals