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/CONTRAST
Jackson, MI
See all hospitals reporting CPT 72193 →Price type
WA Foote Memorial Hospital’s median price of $54 is 89% below the median hospital's median price ($469), higher than 0% 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: 8 payers, 52 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 medicaid-behavioral health-adult-fac professional · fee schedule · outpatient | $34.08 | $34.08 | $34.08 – $34.08 |
| 2 | UnitedHealthcare medicaid-behavioral health-adult-nonfac professional · fee schedule · outpatient | $34.08 | $34.08 | $34.08 – $34.08 |
| 3 | UnitedHealthcare medicaid-behavioral health-child-fac professional · fee schedule · outpatient | $34.08 | $34.08 | $34.08 – $34.08 |
| 4 | UnitedHealthcare medicaid-behavioral health-child-nonfac professional · fee schedule · outpatient | $34.08 | $34.08 | $34.08 – $34.08 |
| 5 | Molina medicaid hmo-adult-fac professional · fee schedule · outpatient | $35.44 | $35.44 | $35.44 – $35.44 |
| 6 | Molina medicaid hmo-child-fac professional · fee schedule · outpatient | $35.44 | $35.44 | $35.44 – $35.44 |
| 7 | Molina medicaid hmo-child-nonfac professional · fee schedule · outpatient | $35.44 | $35.44 | $35.44 – $35.44 |
| 8 | Aetna Better Health medicaid hmo-fac professional · fee schedule · outpatient | $35.78 | $35.78 | $35.78 – $35.78 |
| 9 | Aetna Better Health medicaid hmo-nonfac professional · fee schedule · outpatient | $35.78 | $35.78 | $35.78 – $35.78 |
| 10 | Blue Cross Blue Shield blue cross complete-adult-fac professional · fee schedule · outpatient | $35.78 | $35.78 | $35.78 – $35.78 |
| 11 | Blue Cross Blue Shield blue cross complete-adult-nonfac professional · fee schedule · outpatient | $35.78 | $35.78 | $35.78 – $35.78 |
| 12 | Blue Cross Blue Shield blue cross complete-child-fac professional · fee schedule · outpatient | $35.78 | $35.78 | $35.78 – $35.78 |
| 13 | Blue Cross Blue Shield blue cross complete-child-nonfac professional · fee schedule · outpatient | $35.78 | $35.78 | $35.78 – $35.78 |
| 14 | Molina medicaid hmo-adult-nonfac professional · fee schedule · outpatient | $39.00 | $39.00 | $39.00 – $39.00 |
| 15 | Humana tricare-physician-fac professional · fee schedule · outpatient | $49.20 | $49.20 | $49.20 – $49.20 |
| 16 | Humana tricare-nonphysician-fac professional · fee schedule · outpatient | $50.18 | $50.18 | $50.18 – $50.18 |
| 17 | Aetna medicare advantage/dual products-fac professional · fee schedule · outpatient | $52.58 | $52.58 | $52.58 – $52.58 |
| 18 | Aetna medicare advantage/dual products-nonfac professional · fee schedule · outpatient | $52.58 | $52.58 | $52.58 – $52.58 |
| 19 | Blue Cross Blue Shield bcn medicare advantage -fac professional · fee schedule · outpatient | $52.58 | $52.58 | $52.58 – $52.58 |
| 20 | Blue Cross Blue Shield bcn medicare advantage -nonfac professional · fee schedule · outpatient | $52.58 | $52.58 | $52.58 – $52.58 |
| 21 | Blue Cross Blue Shield medicare plus blue-fac professional · fee schedule · outpatient | $52.58 | $52.58 | $52.58 – $52.58 |
| 22 | Blue Cross Blue Shield medicare plus blue-nonfac professional · fee schedule · outpatient | $52.58 | $52.58 | $52.58 – $52.58 |
| 23 | Humana medicare advantage-fac professional · fee schedule · outpatient | $52.58 | $52.58 | $52.58 – $52.58 |
| 24 | Molina medicare advantage-fac professional · fee schedule · outpatient | $52.58 | $52.58 | $52.58 – $52.58 |
| 25 | Molina medicare advantage-nonfac professional · fee schedule · outpatient | $52.58 | $52.58 | $52.58 – $52.58 |
Last updated: Jun 28, 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.