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.
Original text from hospital filings
CT PELVIS W/DYE
Downers Grove, IL
See all hospitals reporting CPT 72193 →Price type
Advocate Good Samaritan Hospital’s median price of $748 is 59% above the median hospital's median price ($469), higher than 64% of the 2,597 hospitals reporting CPT 72193. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 13 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Ambetter medicare advantage case rate · outpatient | $269.08 | $269.08 | $269.08 – $269.08 |
| 2 | Molina medicare advantage case rate · outpatient | $269.08 | $269.08 | $269.08 – $269.08 |
| 3 | Oscar medicare advantage case rate · outpatient | $278.36 | $278.36 | $278.36 – $278.36 |
| 4 | Cigna commercial case rate · outpatient | $653.00 | $653.00 | $653.00 – $653.00 |
| 5 | UnitedHealthcare commercial case rate · outpatient | $718.00 | $718.00 | $718.00 – $718.00 |
| 6 | UnitedHealthcare hmo case rate · outpatient | $718.00 | $718.00 | $718.00 – $718.00 |
| 7 | Aetna commercial case rate · outpatient | $941.00 | $941.00 | $941.00 – $941.00 |
| 8 | Blue Cross Blue Shield commercial fee schedule · outpatient | $1,361 | $1,361 | $1,307 – $1,414 |
| 9 | Blue Cross Blue Shield managed care percent of total billed charges · outpatientfrom % of charges | $1,376 | $1,376 | $1,376 – $1,376 |
| 10 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $1,403 | $1,403 | $1,403 – $1,403 |
| 11 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $1,424 | $1,424 | $1,424 – $1,424 |
| 12 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $1,424 | $1,424 | $1,424 – $1,424 |
| 13 | Blue Cross Blue Shield ppo fee schedule · outpatient | $1,488 | $1,488 | $1,488 – $1,488 |
Last updated: Nov 4, 2025
See CT scan of pelvis with contrast dye pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.