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
American Fork, UT
See all hospitals reporting CPT 72193 →Price type
IHC Health Services Inc., DBA Intermountain Health American Fork Hospital’s median price of $805 is 71% above the median hospital's median price ($469), higher than 66% 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: 6 payers, 42 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 | Aetna medicare adv hmo professional · fee schedule · outpatient | $110.58 | $110.58 | $54.25 – $166.90 |
| 2 | Aetna medicare adv ppo professional · fee schedule · outpatient | $110.58 | $110.58 | $54.25 – $166.90 |
| 3 | Humana medicare choice ppo professional · fee schedule · outpatient | $110.58 | $110.58 | $54.25 – $166.90 |
| 4 | Molina medicare advantage professional · fee schedule · outpatient | $110.58 | $110.58 | $54.25 – $166.90 |
| 5 | Molina medicare choice care hmo professional · fee schedule · outpatient | $110.58 | $110.58 | $54.25 – $166.90 |
| 6 | Molina medicare complete care hmo snp professional · fee schedule · outpatient | $110.58 | $110.58 | $54.25 – $166.90 |
| 7 | Regence medadvantage ppo professional · fee schedule · outpatient | $110.58 | $110.58 | $54.25 – $166.90 |
| 8 | UnitedHealthcare medicare advantage professional · fee schedule · outpatient | $110.58 | $110.58 | $54.25 – $166.90 |
| 9 | Aetna medicare adv hmo facility · case rate · outpatient | $177.57 | $177.57 | $177.57 – $177.57 |
| 10 | UnitedHealthcare medicare advantage facility · case rate · outpatient | $177.57 | $177.57 | $177.57 – $177.57 |
| 11 | Regence medadvantage ppo facility · case rate · outpatient | $184.67 | $184.67 | $184.67 – $184.67 |
| 12 | Humana medicare choice ppo facility · case rate · outpatient | $186.45 | $186.45 | $186.45 – $186.45 |
| 13 | Aetna medicare adv ppo facility · case rate · outpatient | $195.33 | $195.33 | $195.33 – $195.33 |
| 14 | Molina medicare advantage facility · case rate · outpatient | $195.33 | $195.33 | $195.33 – $195.33 |
| 15 | Molina medicare choice care hmo facility · case rate · outpatient | $195.33 | $195.33 | $195.33 – $195.33 |
| 16 | Molina medicare complete care hmo snp facility · case rate · outpatient | $195.33 | $195.33 | $195.33 – $195.33 |
| 17 | Regence blueoption facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 18 | UnitedHealthcare charter ut facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 19 | UnitedHealthcare non-options ppo facility · fee schedule · outpatient | $805.00 | $805.00 | $805.00 – $805.00 |
| 20 | Regence fehbp facility · fee schedule · outpatient | $917.00 | $917.00 | $917.00 – $917.00 |
| 21 | Regence traditional facility · fee schedule · outpatient | $917.00 | $917.00 | $917.00 – $917.00 |
| 22 | UnitedHealthcare charter ut facility · percent of total billed charges · inpatientfrom % of charges | $1,885 | $1,885 | $1,885 – $1,885 |
| 23 | UnitedHealthcare charter ut facility · percent of total billed charges · outpatientfrom % of charges | $1,885 | $1,885 | $1,885 – $1,885 |
| 24 | Regence blueoption facility · percent of total billed charges · inpatientfrom % of charges | $1,940 | $1,940 | $1,940 – $1,940 |
| 25 | Regence blueoption facility · percent of total billed charges · outpatientfrom % of charges | $1,940 | $1,940 | $1,940 – $1,940 |
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.