CT scan of pelvis with contrast dye at Virtua_Memorial_Hospital_Inc |

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

HC CT Pelvis w/ Contrast

Mount Holly, NJ

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How this price compares nationally

Virtua_Memorial_Hospital_Inc |’s median price of $275 is 41% below the median hospital's median price ($469), higher than 28% 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 Virtua_Memorial_Hospital_Inc |

Negotiated rates from the hospital’s own file: 8 payers, 16 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	Humana commercial case rate · outpatient	$186.77	$186.77	$186.77 – $186.77
2	Blue Cross Blue Shield braven_health case rate · outpatient	$194.55	$194.55	$194.55 – $194.55
3	UnitedHealthcare medicare case rate · outpatient	$194.55	$194.55	$194.55 – $194.55
4	Aetna medicare case rate · outpatient	$196.50	$196.50	$196.50 – $196.50
5	Cigna medicare case rate · outpatient	$198.45	$198.45	$198.45 – $198.45
6	Clover medicare case rate · outpatient	$200.39	$200.39	$200.39 – $200.39
7	Humana medicare case rate · outpatient	$200.39	$200.39	$200.39 – $200.39
8	WellCare medicare case rate · outpatient	$210.12	$210.12	$210.12 – $210.12
9	Cigna local_plus fee schedule · outpatient	$336.34	$336.34	$336.34 – $336.34
10	Cigna hmo fee schedule · outpatient	$396.63	$396.63	$396.63 – $396.63
11	Ambetter medicaid case rate · outpatient	$408.56	$408.56	$408.56 – $408.56
12	UnitedHealthcare commercial fee schedule · outpatient	$410.47	$410.47	$410.47 – $410.47
13	Cigna ppo fee schedule · outpatient	$416.46	$416.46	$416.46 – $416.46
14	Aetna qhp case rate · outpatient	$447.48	$447.48	$447.48 – $447.48
15	Aetna whole_health percent of total billed charges · outpatientfrom % of charges	$3,212	$3,212	$3,212 – $3,212
16	Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges	$4,775	$4,775	$4,775 – $4,775

Last updated: Apr 1, 2026

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