CMS Price Transparency Data

X-ray, hip

Facility: Sonoma Valley Hospital

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73502
  • Insurance Median: $1,024
  • Cash Discount Price: $1,223
  • vs. Medicare Baseline: 11.52x Medicare
The contracted insurance negotiated median rate for a X-ray, hip at Sonoma Valley Hospital is $1,024. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,223. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 11.52x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$1,223

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,024

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)
Cash / Self-Pay: $1,223 (1376%)
Insurance Median: $1,024 (1152%)
Cash: $1,223 (1376% of Medicare)
Ins. Median: $1,024 (1152% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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 1152% of the Medicare baseline (a markup of 1052%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

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

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $34 38%
First Health(Coventry)-All Plans $34 38%
Medi-Cal $53 60%
Mcal Mgd Care (Php)-All Plans $88 99%
Tricare $117 132%
Blue Cross Blue Shield $120 - $1,146 135%
Bright Hlth/Brand New Day Mcr Adv $120 135%
Hospice Of Marin-All Plans $120 135%
St Joseph Heritage Hltcare Comm-All Other Plans $120 135%
Veterans Admin-All Plans $120 135%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $126 142%
Cdcr Prison-All Plans $144 162%
Three Rivers (Trpn)-All Plans $144 162%
Chp - Correctional Health Partners - All Plans $156 175%
Bright Hlth/Brand New Day - All Other Plands $162 182%
Wellpath - All Plans $168 189%
Partnership Healthplan-All Plans $187 210%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $215 242%
Canopy Health Solutions-All Other Plans $215 242%
Healthnet Hmo/Ppo-All Other Plans $611 687%
Blue Shield Ppo-All Plans $992 1116%
Comm Care Network(Ccn)-All Plans $1,000 1125%
UnitedHealthcare $1,048 1179%
Kaiser-All Plans $1,136 1278%
Integrated Health Plan-All Plans $1,293 1454%
Champus-All Plans $1,398 1572%
Cigna $1,398 1572%
Networks By Design - All Plans $1,398 1572%
Great West-One Health Plan Ppo/Pos-All Plans $1,485 1670%
Phcs/Multiplan/Beech St-All Plans $1,485 1670%
Interplan-All Plans $1,537 1729%
Bps-All Plans $1,572 1768%
Ppo Alliance-All Plans $1,572 1768%
Pref Health Networl(Phn)-All Plans $1,572 1768%
Meritage Medical Network Op Only Mcare $1,747 1965%
Scan Mcare-All Plans $1,747 1965%
St Joseph Heritage Hltcare Mcr Adv $1,747 1965%
Correct Care Integ Health-All Plans $2,096 2357%
Employer Direct Healthcare-All Plans $2,096 2357%
Meritage Medical Network Op Only-All Other Plans $2,201 2476%
Creative Legal Services-All Plans $2,271 2554%
Canopy Op Only $3,145 3537%
Vnpn - All Plans $3,145 3537%

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