CT scan of the pelvis, combination study

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC CT SCAN OF PELVIS COMBO - CT PELVIS W WO CONTRA

Payers reporting CPT 72194

Payer pricing summary

Low

$161

Average

$1.6k

Median

$904

High

$16.1k

Payer rate distribution

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#
1	Medicare other · both · +22 other terms	43	$186	$256	$347	136%	29–164	$163 – $2.4k
2	Bcbs Al facility · other · outpatient · +4 other terms	4	$449	$497	$54	11%	4–40	$417 – $545
3	Blue Cross Blue Shield fee schedule · outpatient · +36 other terms	540	$469	$644	$814	126%	3–30	$1 – $15.8k
4	UnitedHealthcare fee schedule · outpatient · +39 other terms	800	$352	$451	$601	133%	2–20	$1 – $8.1k
5	Molina fee schedule · outpatient · +35 other terms	257	$228	$248	$152	61%	2–20	$1 – $2.1k
6	Anthem fee schedule · outpatient · +35 other terms	213	$551	$472	$560	119%	2–20	$4 – $7.7k
7	Cigna fee schedule · outpatient · +34 other terms	365	$564	$808	$1.0k	128%	1–10	$1 – $10.9k
8	Aetna fee schedule · outpatient · +39 other terms	635	$372	$861	$995	116%	—	$1 – $10.6k
9	Humana fee schedule · outpatient · +34 other terms	458	$214	$547	$820	150%	—	$1 – $7.6k
10	WellCare fee schedule · outpatient · +26 other terms	205	$190	$247	$169	68%	—	$60 – $1.3k
11	MultiPlan fee schedule · outpatient · +24 other terms	136	$2.3k	$2.5k	$2.7k	108%	—	$74 – $17.8k
12	Ambetter fee schedule · outpatient · +25 other terms	121	$293	$293	$306	104%	—	$45 – $2.6k
13	Devoted facility · fee schedule · outpatient · +20 other terms	113	$176	$203	$307	151%	—	$152 – $4.9k
14	Kaiser fee schedule · outpatient · +27 other terms	112	$374	$756	$1.3k	166%	—	$57 – $7.5k
15	Caresource fee schedule · outpatient · +21 other terms	95	$267	$392	$289	74%	—	$1 – $1.3k
16	Tricare facility · fee schedule · outpatient · +21 other terms	94	$176	$240	$416	173%	—	$113 – $4.6k
17	Aetna Better Health fee schedule · outpatient · +19 other terms	85	$195	$205	$59	29%	—	$93 – $541
18	Highmark facility · fee schedule · outpatient · +21 other terms	76	$279	$462	$565	122%	—	$42 – $2.9k
19	Optum facility · fee schedule · outpatient · +23 other terms	70	$171	$191	$107	56%	—	$151 – $1.1k
20	Oscar facility · fee schedule · outpatient · +22 other terms	67	$278	$278	$61	22%	—	$163 – $379
21	Medicaid facility · fee schedule · outpatient · +19 other terms	65	$178	$212	$83	39%	—	$101 – $386
22	First Health fee schedule · outpatient · +22 other terms	63	$1.1k	$1.7k	$2.7k	155%	—	$68 – $15.6k
23	Amerihealth Caritas facility · fee schedule · outpatient · +17 other terms	57	$191	$247	$124	50%	—	$103 – $693
24	Medica fee schedule · outpatient · +26 other terms	51	$720	$1.1k	$1.2k	110%	—	$54 – $6.0k
25	Cigna Healthspring fee schedule · outpatient · +11 other terms	42	$184	$197	$46	24%	—	$163 – $355

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