CMS Price Transparency Data

CT scan, pelvis

Facility: San Gabriel Valley Medical Center

Billing Code: 72192 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$165
about 1.5× the $107 Medicare rate · typically $137–$196
modeled estimate · not a bill or quote
What this hospital charges insurers
$177
About the fair price
about $12 over the fair price · 1.7× Medicare
Medicare pays $107 Fair price $165 This hospital $177 Cash price $1,025 Hospital's list price $3,417

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

Highest price of the 9 CA hospitals we have prices for — worth calling around.

Cheapest $46 Priciest $177

Black dot = this hospital, among the 9 CA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, pelvis is about $165 (about 1.5× the $107 Medicare rate). San Gabriel Valley Medical Center charges insurers about $177, or about $1,025 in cash — about the fair price. Located in San Gabriel, CA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $132 - $170 124%
Blue Cross Blue Shieldmajor $40 - $2,528 37%
Aetnamajor $132 - $285 124%
Cignamajor $1,550 1451%
Humanamajor $132 124%
Health Net $128 - $4,457 120%
Molina $132 - $450 124%
Presbyterian $334 313%
WellCare $132 124%
+ 28 smaller / regional plans $128 - $4,457
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 438 W Las Tunas Drive, San Gabriel, CA 91776
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals