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
HC CT PELVIS W/CONTRAST
Panguitch, UT
See all hospitals reporting CPT 72193 →Price type
Garfield County, a political subdivision of the State of Utah, DBA Intermountain Health Garfield Memorial Hospital’s median price of $2.8k is 496% above the median hospital's median price ($469), higher than 95% 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: 7 payers, 47 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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Filter by billing class
| # | ||||
|---|---|---|---|---|
| 1 | Aetna aetna medicare hmo professional · fee schedule · outpatient | $110.58 | $110.58 | $54.25 – $166.90 |
| 2 | Aetna aetna medicare ppo professional · fee schedule · outpatient | $110.58 | $110.58 | $54.25 – $166.90 |
| 3 | Molina medicaid professional · fee schedule · outpatient | $110.58 | $110.58 | $54.25 – $166.90 |
| 4 | Molina molina healthcare medicaid hmo professional · fee schedule · outpatient | $110.58 | $110.58 | $54.25 – $166.90 |
| 5 | Molina molina medicare complete care hmo snp professional · fee schedule · outpatient | $110.58 | $110.58 | $54.25 – $166.90 |
| 6 | Aetna aetna standard network aka aetna health plan network for utah facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 7 | Aetna aetna utah connected network facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 8 | Aetna aetna whole health connected utah network facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 9 | Cigna cigna managed care (hmo or open access plus aka oap) facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 10 | Cigna ppo/epo facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 11 | Aetna aetna medicare hmo facility · percent of total billed charges · outpatientfrom % of charges | $1,194 | $1,194 | $1,194 – $1,194 |
| 12 | Aetna aetna medicare ppo facility · percent of total billed charges · outpatientfrom % of charges | $1,194 | $1,194 | $1,194 – $1,194 |
| 13 | Molina medicaid facility · percent of total billed charges · outpatientfrom % of charges | $1,194 | $1,194 | $1,194 – $1,194 |
| 14 | Molina molina healthcare medicaid hmo facility · percent of total billed charges · outpatientfrom % of charges | $1,194 | $1,194 | $1,194 – $1,194 |
| 15 | Molina molina medicare complete care hmo snp facility · percent of total billed charges · outpatientfrom % of charges | $1,320 | $1,320 | $1,320 – $1,320 |
| 16 | Tricare tricare (hnfs) military program facility · percent of total billed charges · outpatientfrom % of charges | $1,361 | $1,361 | $1,361 – $1,361 |
| 17 | Tricare tricare (hnfs) military program facility · percent of total billed charges · inpatientfrom % of charges | $1,618 | $1,618 | $1,618 – $1,618 |
| 18 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $2,576 | $2,576 | $2,576 – $2,576 |
| 19 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $2,639 | $2,639 | $2,639 – $2,639 |
| 20 | Molina medicaid facility · percent of total billed charges · inpatientfrom % of charges | $2,796 | $2,796 | $2,796 – $2,796 |
| 21 | Molina molina healthcare medicaid hmo facility · percent of total billed charges · inpatientfrom % of charges | $2,796 | $2,796 | $2,796 – $2,796 |
| 22 | Aetna aetna extended network facility · percent of total billed charges · inpatientfrom % of charges | $2,985 | $2,985 | $2,985 – $2,985 |
| 23 | Aetna aetna standard network aka aetna health plan network for utah facility · percent of total billed charges · inpatientfrom % of charges | $2,985 | $2,985 | $2,985 – $2,985 |
| 24 | Aetna aetna standard network aka aetna health plan network for utah facility · percent of total billed charges · outpatientfrom % of charges | $2,985 | $2,985 | $2,985 – $2,985 |
| 25 | Aetna aetna utah connected network facility · percent of total billed charges · inpatientfrom % of charges | $2,985 | $2,985 | $2,985 – $2,985 |
Last updated: Aug 5, 2026
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.