CMS Price Transparency Data

CT scan, pelvis

Facility: Greater El Monte Community Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $926
  • Cash Discount Price: $2,467
  • vs. Medicare Baseline: 8.67x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Greater El Monte Community Hospital is $926. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,467. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.67x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$2,467

Average discount available for prompt cash payment at this facility.

Insurance Median
$926

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: $2,467 (2310%)
Insurance Median: $926 (867%)
Cash: $2,467 (2310% of Medicare)
Ins. Median: $926 (867% 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 867% of the Medicare baseline (a markup of 767%). 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
In Custody-Ca Highway Patrol $20 19%
Blue Cross Blue Shield $40 - $1,438 37%
Veterans Administration $94 88%
Associated Hispanic Physicians $121 - $334 113%
Aids Health Foundation $128 - $132 120%
Altamed Health Network $128 - $132 120%
Avanti $128 - $161 120%
Beverly Hospital $128 - $148 120%
Brand New Day $128 - $168 120%
Emanate Health $128 - $168 120%
Health Net Foundation $128 - $1,869 120%
Healthy Way La $128 120%
La Care Health Plan $128 - $1,582 120%
Other Non Contracted Medi-Cal Hmo $128 120%
State Of California $128 120%
Apa/Aco Inc $132 124%
Blue Shield Of California $132 - $2,505 124%
Cms $132 124%
Easy Choice Health Plan $132 124%
Health Net Inc $132 - $2,036 124%
Other Non Contracted Senior Hmo $132 124%
Pacific Alliance Medical Center Reciprocal Contract $132 124%
Scan Health Plan $132 124%
UnitedHealthcare $132 - $2,469 124%
Champus Foundation $134 125%
Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P $134 125%
Good Samaritan Medical Practice Assoc $134 - $1,726 125%
La Care Covered Direct $134 125%
Pacificare Of California $134 125%
Self-Pay $134 125%
Alignment Health Plan $139 130%
Molina Healthcare $139 130%
Inter Valley Health Plan $141 132%
Molina Healthcare Of California $141 - $450 132%
San Miguel Health Plan $148 139%
Chinatown Service Center Pace $159 149%
Intercomp $161 151%
Ahmc Health Self-Insurance Epo $168 157%
Knox-Keene Act $168 157%
Preferred Health Network $170 159%
Interplan $173 - $2,157 162%
Athens Administrators $179 168%
Multiplan $179 - $2,445 168%
Other Non Contracted Work Comp $179 168%
Caloptima $188 176%
Care 1St Medi Cal Hmo Cap Exceptional Care $200 187%
Clinica Medica Familiar $226 - $316 212%
Universal Care $250 - $1,250 234%
Central Health Plan $300 - $598 281%
Hollywood Presbyterian Adv Med Mcal $334 313%
Hollywood Presbyterian Medpoint Mcal $334 313%
Ahmc Reciprocity Agreement $345 323%
Bella Vista Medical Group Ipa $411 - $1,294 385%
Global Care Medical Group Ipa $411 - $1,294 385%
Cost Containment Strategies $450 421%
Employee Health Systems Medical Group $450 421%
Alta Med Health Services Med Grp $514 - $719 481%
Ahmc Reciprocity Agreement Senior/Commercial $617 - $863 578%
California Thoroughbred Horesmans Foundation $1,028 - $1,438 962%
In Custody Police Dept $1,337 - $1,869 1252%
Cigna $1,565 1465%
Community Care Network $1,646 - $2,301 1541%
Health Payors Organization $1,851 - $2,588 1733%
Commercial Non Contract $2,057 - $2,876 1926%
Medi-Cal Sub Acute $2,057 - $2,876 1926%
Nuclear Medicine/Whmc $2,057 - $2,876 1926%
One Legacy $2,057 - $2,876 1926%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Santa Anita Ave, South El Monte, CA 91733
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals