CMS Price Transparency Data

CT scan, pelvis

Facility: Menifee Global Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,191
  • Cash Discount Price: $2,177
  • vs. Medicare Baseline: 11.15x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Menifee Global Medical Center is $1,191. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,177. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.15x the Medicare baseline. Located in 28400 McCall Boulevard, Sun City, CA.
Cash / Self-Pay
$2,177

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,191

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: $2,177 (2038%)
Insurance Median: $1,191 (1115%)
Cash: $2,177 (2038% of Medicare)
Ins. Median: $1,191 (1115% 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 1115% of the Medicare baseline (a markup of 1015%). 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
Tricare $121 - $125 113%
Aetna $134 - $2,026 125%
Altamed Comm Hmo (Ancillary) $134 - $3,708 125%
Altamed Health Services Senior $134 125%
Altamed Sr/Pace $134 125%
Blue Shield Senior $134 125%
Central Health Plan Senior $134 125%
Clever Care Health Plan Sr $134 125%
For Your Benefit Senior $134 125%
Guidant Health Plan Senior $134 125%
Health Net Senior $134 125%
Hpn Senior $134 125%
Humana $134 125%
Ic $134 - $3,708 125%
Imperial Health Plan Of Ca $134 125%
Kaiser Senior $134 125%
Lasalle Medical Assoc (Ancillary) Commercial $134 125%
Lasalle Medical Assoc (Ancillary) Senior $134 125%
Managed Health Network Sr $134 125%
Medicare (plans) $134 125%
Neighborhood Healthcare Pace $134 125%
Point Comfort Underwriters $134 125%
Primecare Senior $134 125%
Prospect Health Plan Sr Hmo $134 125%
Scan Senior $134 125%
Self Pay/Ab774/Charity Discount $134 125%
Sr Capitation $134 125%
UnitedHealthcare $134 - $174 125%
Veterans Administration $134 125%
Align Senior Care $150 140%
Welbehealth Sr/Pace $150 140%
Lasalle Medical Assoc (Ancillary) Mcal Hmo $151 141%
Prime Health Services Senior $154 144%
Molina Covered Ca $159 149%
Coventry $161 - $167 151%
Prime Health Services Wcomp $161 151%
Iehp Covered Ca $167 156%
Three Rivers Wcomp $175 164%
Cigna $178 - $2,966 167%
Workers Comp Non-Contracted $179 168%
Prospect Health Plan Comm Hmo $181 169%
Health Net Enhanced Ppo $187 - $199 175%
Hpn Commercial/Covered Ca $187 175%
Health Net Comm $201 188%
Three Rivers Network $235 220%
Velocity $235 - $1,669 220%
Health Net Medi-Cal $334 313%
Hpn Mcal $334 313%
Kaiser Medi-Cal $334 313%
Prospect Health Plan Mcal Hmo $344 322%
Blue Cross Blue Shield $350 328%
Blue Shield Epn $376 352%
Molina Medi-Cal $394 369%
Blue Shield Commercial $443 415%
Altamed Mcal Hmo $467 437%
Altamed Mcal/Pace $467 437%
Choice Physicians Network $467 437%
Iehp Medi-Cal $501 469%
Primecare Commercial $635 595%
First Health Commercial $782 - $1,947 732%
Multiplan Ppo $1,042 - $2,596 976%
Multiplan Wcomp $1,042 - $2,596 976%
Pnoa-Provider Network Of America $1,191 - $2,966 1115%
Prime Health Services Commercial $1,191 - $2,966 1115%
Ava Hospice $1,489 - $3,708 1394%
Kaiser Commercial $1,489 - $3,708 1394%
Living Waters Hospice $1,489 - $3,708 1394%
Managed Health Network $1,489 - $3,708 1394%
Other Insurance Loa $1,489 - $3,708 1394%
Pacific Valley Hospice $1,489 - $3,708 1394%
Private Pay $1,489 - $3,708 1394%
Silverado Hospice $1,489 - $3,708 1394%
Vna Hospice $1,489 - $3,708 1394%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 28400 McCall Boulevard, Sun City, CA 92585
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals