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
COMPUTED TOMOGRAPHY, PELVIS; WITH CONTRA
Canandaigua, NY
See all hospitals reporting CPT 72193 →Price type
F.F. Thompson Hospital’s median price of $206 is 56% below the median hospital's median price ($469), higher than 15% 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: 9 payers, 19 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 | Blue Cross Blue Shield amerigroup (bswny alternate) 172001 fee schedule · outpatient | $137.36 | $137.36 | $103.02 – $171.70 |
| 2 | Excellus blue choice option medicaid 170601 fee schedule · outpatient | $137.36 | $137.36 | $103.02 – $171.70 |
| 3 | Excellus excellus essential 3-4 170604, excellus essential 1-2 200-250 2201, excellus child health plus 220108, excellus hlthy ny 220110 fee schedule · outpatient | $137.36 | $137.36 | $103.02 – $171.70 |
| 4 | Highmark highmark bcbs essential 1-2 200-250 5143 fee schedule · outpatient | $137.36 | $137.36 | $103.02 – $171.70 |
| 5 | Highmark highmark bcbs medicaid 170201 child health plus 170204 fee schedule · outpatient | $137.36 | $137.36 | $103.02 – $171.70 |
| 6 | UnitedHealthcare united healthcare essential 1-2 200-250 5158 fee schedule · outpatient | $137.36 | $137.36 | $103.02 – $171.70 |
| 7 | UnitedHealthcare united healthcare medicaid 171601, united healthcare essential 3-4 171602, united healthcare child health plus 515813 fee schedule · outpatient | $137.36 | $137.36 | $103.02 – $171.70 |
| 8 | Highmark highmark bcbs 514301 fee schedule · outpatient | $181.82 | $181.82 | $181.82 – $181.82 |
| 9 | Molina molina medicaid 172301, molina child health plus 518901 fee schedule · outpatient | $214.62 | $214.62 | $214.62 – $214.62 |
| 10 | Aetna aetna medicare 130001 fee schedule · outpatient | $218.95 | $218.95 | $218.95 – $218.95 |
| 11 | Highmark highmark bcbs medicare 130101 fee schedule · outpatient | $218.95 | $218.95 | $218.95 – $218.95 |
| 12 | Humana humana medicare 131201 fee schedule · outpatient | $218.95 | $218.95 | $218.95 – $218.95 |
| 13 | UnitedHealthcare united healthcare medicare 130901 fee schedule · outpatient | $218.95 | $218.95 | $218.95 – $218.95 |
| 14 | WellCare wellcare medicare 131001 fee schedule · outpatient | $218.95 | $218.95 | $218.95 – $218.95 |
| 15 | Molina molina essential 3-4 172302, molina essential 1-2 200-250 5189 fee schedule · outpatient | $386.32 | $386.32 | $386.32 – $386.32 |
| 16 | Excellus excellus metal tiers 220102 fee schedule · outpatient | $391.13 | $391.13 | $391.13 – $391.13 |
| 17 | Cigna mvp commercial ppo fully insured 290006, cigna healthcare (pob 182223) 514405 fee schedule · outpatient | $511.91 | $511.91 | $511.91 – $511.91 |
| 18 | Excellus excellus 220101, excellus simply blue 220106, excellus blue choice 220107 fee schedule · outpatient | $604.59 | $604.59 | $604.59 – $604.59 |
| 19 | Aetna aetna 270002 percent of total billed charges · outpatientfrom % of charges | $1,010 | $1,010 | $1,010 – $1,010 |
Last updated: Jan 1, 2026
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