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/ IV CONTRAST (NO ORAL CONT)
Gaylord, MI
See all hospitals reporting CPT 72193 →Price type
Munson Healthcare Otsego Memorial Hospital’s median price of $232 is 51% below the median hospital's median price ($469), higher than 21% 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, 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 | Molina managed medicaid professional · fee schedule · both | $34.72 | $34.72 | $34.72 – $34.72 |
| 2 | Blue Cross Blue Shield managed medicaid professional · fee schedule · both | $35.41 | $35.41 | $35.41 – $35.41 |
| 3 | Blue Cross Blue Shield managed medicaid facility · fee schedule · outpatient | $91.40 | $91.40 | $91.40 – $91.40 |
| 4 | Molina managed medicaid facility · fee schedule · outpatient | $91.40 | $91.40 | $91.40 – $91.40 |
| 5 | UnitedHealthcare managed medicaid facility · fee schedule · outpatient | $91.40 | $91.40 | $91.40 – $91.40 |
| 6 | UnitedHealthcare medicare advantage professional · fee schedule · both | $110.25 | $98.04 | $36.81 – $147.06 |
| 7 | Humana medicare advantage professional · fee schedule · both | $157.50 | $140.05 | $52.58 – $210.08 |
| 8 | Aetna medicare advantage professional · fee schedule · both | $159.08 | $141.46 | $53.11 – $212.18 |
| 9 | Molina medicare advantage professional · fee schedule · both | $170.10 | $151.26 | $56.79 – $226.89 |
| 10 | UnitedHealthcare managed medicaid professional · fee schedule · both | $187.03 | $159.58 | $34.72 – $257.00 |
| 11 | Humana medicare advantage facility · fee schedule · outpatient | $174.77 | $174.77 | $174.77 – $174.77 |
| 12 | UnitedHealthcare medicare advantage facility · fee schedule · outpatient | $174.77 | $174.77 | $174.77 – $174.77 |
| 13 | Aetna medicare advantage facility · fee schedule · outpatient | $176.52 | $176.52 | $176.52 – $176.52 |
| 14 | UnitedHealthcare commercial professional · fee schedule · both | $187.03 | $182.47 | $62.66 – $297.72 |
| 15 | Molina medicare advantage facility · fee schedule · outpatient | $188.75 | $188.75 | $188.75 – $188.75 |
| 16 | Cigna commercial professional · fee schedule · both | $264.42 | $230.79 | $81.77 – $346.19 |
| 17 | Blue Cross Blue Shield ppo/traditional/hmo/blue care network commercial professional · fee schedule · both | $280.68 | $244.99 | $86.81 – $367.49 |
| 18 | Cigna commercial facility · fee schedule · outpatient | $634.10 | $634.10 | $634.10 – $634.10 |
| 19 | Blue Cross Blue Shield ppo/traditional/hmo/blue care network commercial facility · percent of total billed charges · inpatientfrom % of charges | $1,270 | $1,270 | $1,270 – $1,270 |
| 20 | Blue Cross Blue Shield ppo/traditional/hmo/blue care network commercial facility · percent of total billed charges · outpatientfrom % of charges | $1,270 | $1,270 | $1,270 – $1,270 |
| 21 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $1,629 | $1,629 | $1,629 – $1,629 |
| 22 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $1,629 | $1,629 | $1,629 – $1,629 |
| 23 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $1,648 | $1,648 | $1,648 – $1,648 |
| 24 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $1,648 | $1,648 | $1,648 – $1,648 |
Last updated: Apr 17, 2026
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