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
PR CT PELVIS W CNTRST
Fairmont 56031-4575
See all hospitals reporting CPT 72193 →Price type
Mayo Clinic Health System’s median price of $667 is 42% above the median hospital's median price ($469), higher than 59% 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: 13 payers, 24 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 blue cross blue shield mncare contract [1410] professional · fee schedule · outpatient | $114.82 | $114.82 | $42.82 – $186.81 |
| 2 | Blue Cross Blue Shield blue cross blue shield federal retiree [1124] professional · fee schedule · outpatient | $140.61 | $140.61 | $52.18 – $229.04 |
| 3 | Optum veteran affairs optum [1054] professional · fee schedule · outpatient | $140.61 | $140.61 | $52.18 – $229.04 |
| 4 | Blue Cross Blue Shield blueplus with mayo clinic [239] professional · percent of total billed charges · outpatientfrom % of charges | $1,340 | $1,340 | $584.80 – $2,095 |
| 5 | Medica deanhp by medica west mc hmo [1262] professional · percent of total billed charges · outpatientfrom % of charges | $1,387 | $1,387 | $605.44 – $2,169 |
| 6 | Medica medica complete health and engage [209] professional · percent of total billed charges · outpatientfrom % of charges | $1,387 | $1,387 | $605.44 – $2,169 |
| 7 | Blue Cross Blue Shield blue cross blue shield fep [867] professional · percent of total billed charges · outpatientfrom % of charges | $1,394 | $1,394 | $608.26 – $2,179 |
| 8 | Anthem blue cross blue shield [237] professional · percent of total billed charges · outpatientfrom % of charges | $1,419 | $1,419 | $619.20 – $2,219 |
| 9 | Blue Cross Blue Shield blue cross blue shield [237] professional · percent of total billed charges · outpatientfrom % of charges | $1,419 | $1,419 | $619.20 – $2,219 |
| 10 | Medica medica non mayo employee group [763] professional · percent of total billed charges · outpatientfrom % of charges | $1,419 | $1,419 | $619.20 – $2,219 |
| 11 | Medica medica choice [205] professional · percent of total billed charges · outpatientfrom % of charges | $1,482 | $1,482 | $646.72 – $2,317 |
| 12 | Aetna aetna [214] professional · percent of total billed charges · outpatientfrom % of charges | $1,498 | $1,498 | $653.60 – $2,342 |
| 13 | Aetna all other plans [214] professional · percent of total billed charges · outpatientfrom % of charges | $1,498 | $1,498 | $653.60 – $2,342 |
| 14 | Blue Cross Blue Shield blue cross blue shield tiered network [890] professional · percent of total billed charges · outpatientfrom % of charges | $1,498 | $1,498 | $653.60 – $2,342 |
| 15 | Cigna all other plans [287] professional · percent of total billed charges · outpatientfrom % of charges | $1,498 | $1,498 | $653.60 – $2,342 |
| 16 | First Health aetna [214] professional · percent of total billed charges · outpatientfrom % of charges | $1,498 | $1,498 | $653.60 – $2,342 |
| 17 | Healthpartners cigna [287] professional · percent of total billed charges · outpatientfrom % of charges | $1,498 | $1,498 | $653.60 – $2,342 |
| 18 | Humana cigna [287] professional · percent of total billed charges · outpatientfrom % of charges | $1,498 | $1,498 | $653.60 – $2,342 |
| 19 | Medcost cigna [287] professional · percent of total billed charges · outpatientfrom % of charges | $1,498 | $1,498 | $653.60 – $2,342 |
| 20 | Medica coventry first health [271] professional · percent of total billed charges · outpatientfrom % of charges | $1,498 | $1,498 | $653.60 – $2,342 |
| 21 | Medical Mutual aetna [214] professional · percent of total billed charges · outpatientfrom % of charges | $1,498 | $1,498 | $653.60 – $2,342 |
| 22 | Oscar cigna [287] professional · percent of total billed charges · outpatientfrom % of charges | $1,498 | $1,498 | $653.60 – $2,342 |
| 23 | Sanford Health Plan private healthcare systems healtheos [310] professional · percent of total billed charges · outpatientfrom % of charges | $1,498 | $1,498 | $653.60 – $2,342 |
| 24 | Blue Cross Blue Shield blue cross blue shield out of network [891] professional · percent of total billed charges · outpatientfrom % of charges | $1,529 | $1,529 | $667.36 – $2,391 |
Last updated: Mar 31, 2026
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