CT scan of pelvis with contrast dye at Medical City Arlington

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

CT PELVIS W/CONTRAST

RED OAK, TX

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How this price compares nationally

Medical City Arlington’s median price of $673 is 43% above the median hospital's median price ($469), higher than 60% of the 2,597 hospitals reporting CPT 72193. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 72193 at Medical City Arlington

Negotiated rates from the hospital’s own file: 10 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	UnitedHealthcare chip fee schedule · outpatient	$175.06	$175.06	$175.06 – $175.06
2	UnitedHealthcare star fee schedule · outpatient	$175.06	$175.06	$175.06 – $175.06
3	UnitedHealthcare starkids fee schedule · outpatient	$175.06	$175.06	$175.06 – $175.06
4	UnitedHealthcare starperinate fee schedule · outpatient	$175.06	$175.06	$175.06 – $175.06
5	UnitedHealthcare starplus fee schedule · outpatient	$175.06	$175.06	$175.06 – $175.06
6	Cigna Healthspring mgmcd fee schedule · outpatient	$183.81	$183.81	$183.81 – $183.81
7	Aetna Better Health chip fee schedule · outpatient	$189.06	$189.06	$189.06 – $189.06
8	Aetna Better Health mcd fee schedule · outpatient	$189.06	$189.06	$189.06 – $189.06
9	Molina chip fee schedule · outpatient	$194.32	$194.32	$192.57 – $196.07
10	Molina mcdstar fee schedule · outpatient	$194.32	$194.32	$192.57 – $196.07
11	Molina star+plus fee schedule · outpatient	$194.32	$194.32	$192.57 – $196.07
12	Molina starkids fee schedule · outpatient	$194.32	$194.32	$192.57 – $196.07
13	Blue Cross Blue Shield bluepremier fee schedule · outpatient	$216.84	$216.84	$216.84 – $216.84
14	Humana mgmcd fee schedule · outpatient	$218.82	$218.82	$218.82 – $218.82
15	Blue Cross Blue Shield blueadvantagehmo fee schedule · outpatient	$229.60	$229.60	$229.60 – $229.60
16	Blue Cross Blue Shield mybluehealth fee schedule · outpatient	$229.60	$229.60	$229.60 – $229.60
17	UnitedHealthcare narrownetworkindivexchange fee schedule · outpatient	$341.20	$341.20	$341.20 – $341.20
18	UnitedHealthcare smallgroup fee schedule · outpatient	$341.20	$341.20	$341.20 – $341.20
19	UnitedHealthcare allpayerappendix fee schedule · outpatient	$401.74	$401.74	$401.74 – $401.74
20	Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges	$496.47	$496.47	$496.47 – $496.47
21	Superior Healthplan mcdstar percent of total billed charges · outpatientfrom % of charges	$496.47	$496.47	$496.47 – $496.47
22	Superior Healthplan starhealth percent of total billed charges · outpatientfrom % of charges	$496.47	$496.47	$496.47 – $496.47
23	Superior Healthplan starkids percent of total billed charges · outpatientfrom % of charges	$496.47	$496.47	$496.47 – $496.47
24	Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges	$496.47	$496.47	$496.47 – $496.47
25	Aetna qhphix other · outpatient	$584.00	$584.00	$584.00 – $584.00

Page 1 of 2 · 42 rates

Last updated: Mar 1, 2026

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