CMS Price Transparency Data

CT scan, pelvis

Facility: Sonoma Valley Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $2,681
  • Cash Discount Price: $3,919
  • vs. Medicare Baseline: 25.10x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Sonoma Valley Hospital is $2,681. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,919. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 25.10x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$3,919

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,681

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $3,919 (3669%)
Insurance Median: $2,681 (2510%)
Cash: $3,919 (3669% of Medicare)
Ins. Median: $2,681 (2510% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 2510% of the Medicare baseline (a markup of 2410%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Tricare $141 132%
Blue Cross Blue Shield $144 - $3,673 135%
Bright Hlth/Brand New Day Mcr Adv $144 135%
Hospice Of Marin-All Plans $144 135%
St Joseph Heritage Hltcare Comm-All Other Plans $144 135%
Veterans Admin-All Plans $144 135%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $151 141%
Cdcr Prison-All Plans $173 162%
Three Rivers (Trpn)-All Plans $173 162%
Chp - Correctional Health Partners - All Plans $187 175%
Bright Hlth/Brand New Day - All Other Plands $194 182%
Wellpath - All Plans $201 188%
Medi-Cal $205 192%
Aetna $217 203%
First Health(Coventry)-All Plans $217 203%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $259 242%
Canopy Health Solutions-All Other Plans $259 242%
Mcal Mgd Care (Php)-All Plans $338 316%
UnitedHealthcare $486 455%
Partnership Healthplan-All Plans $716 670%
Comm Care Network(Ccn)-All Plans $1,000 936%
Healthnet Hmo/Ppo-All Other Plans $2,183 2044%
Blue Shield Ppo-All Plans $3,180 2977%
Kaiser-All Plans $3,639 3407%
Integrated Health Plan-All Plans $4,143 3879%
Champus-All Plans $4,478 4192%
Cigna $4,478 4192%
Networks By Design - All Plans $4,478 4192%
Great West-One Health Plan Ppo/Pos-All Plans $4,758 4455%
Phcs/Multiplan/Beech St-All Plans $4,758 4455%
Interplan-All Plans $4,926 4612%
Bps-All Plans $5,038 4717%
Ppo Alliance-All Plans $5,038 4717%
Pref Health Networl(Phn)-All Plans $5,038 4717%
Meritage Medical Network Op Only Mcare $5,598 5241%
Scan Mcare-All Plans $5,598 5241%
St Joseph Heritage Hltcare Mcr Adv $5,598 5241%
Correct Care Integ Health-All Plans $6,718 6290%
Employer Direct Healthcare-All Plans $6,718 6290%
Meritage Medical Network Op Only-All Other Plans $7,053 6603%
Creative Legal Services-All Plans $7,277 6813%
Canopy Op Only $10,076 9434%
Vnpn - All Plans $10,076 9434%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals