CMS Price Transparency Data

CT scan, pelvis

Facility: Adventist Health Lodi Memorial

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $153
  • Cash Discount Price: $90
  • vs. Medicare Baseline: 1.43x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Adventist Health Lodi Memorial is $153. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.43x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.
Cash / Self-Pay
$90

Average discount available for prompt cash payment at this facility.

Insurance Median
$153

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: $90 (84%)
Insurance Median: $153 (143%)
Cash: $90 (84% of Medicare)
Ins. Median: $153 (143% 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.

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
Cigna $29 - $7,999 27%
Alignment Health Plan (Ahp)-All Plans $51 - $138 48%
Blue Shield Mcare Adv $51 - $138 48%
Healthnet Mcare $51 - $138 48%
Hp Of San Joaquin Mcr Adv $51 - $138 48%
Humana $51 - $138 48%
Knnex Health - All Plans $51 - $165 48%
Tricare $51 - $138 48%
UnitedHealthcare $51 - $3,689 48%
Hp Healthy Kids Pro Fee $53 50%
Ah Employee Health Plan - All Plans $56 - $248 52%
First Health- All Plans $61 - $5,500 57%
Beech Street- All Plans $66 - $7,999 62%
Hp Of San Joaquin Ppo - All Other Plans $66 - $8,444 62%
Multiplan- All Plans $66 - $7,110 62%
Kaiser Commercial - All Other Plans $68 - $3,644 64%
Kaiser Mcr Adv $68 - $138 64%
Networks By Design- All Plans $68 - $3,500 64%
Healthnet- All Other Plans $74 - $4,365 69%
Western Growers- All Plans $77 - $7,999 72%
Blue Shield Epn - All Other Plans $94 - $2,880 88%
Blue Cross Blue Shield $96 - $1,843 90%
Blue Shield Non-Epn $99 - $2,986 93%
Bc Mcal $101 - $138 95%
Celtic Ins Company - All Plans $101 - $229 95%
Healthnet Mcal $101 - $292 95%
Hp Mcal Pro Fee $101 - $140 95%
Hp Of San Joaquin Mcal $101 - $256 95%
Kaiser Mcal $101 - $205 95%
Medi-Cal $101 - $205 95%
Cca Health Plan Mcr Adv- All Plans $138 129%
Aetna $275 - $2,266 257%
Bright Health - All Plans $276 258%
Medcore(Omni Ipa) Op Only- All Plans $613 - $2,311 574%
Three Rivers Provider Network- All Plans $2,120 - $7,999 1985%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 S Fairmont Avenue, Lodi, CA 95240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals