CMS Price Transparency Data

CT scan, pelvis

Facility: Loma Linda University Children's Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $948
Cash Discount Price: $1,638
vs. Medicare Baseline: 8.88x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Loma Linda University Children's Hospital is $948. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,638. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.88x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$1,638

Average discount available for prompt cash payment at this facility.

Insurance Median

$948

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: $1,638 (1534%)

Insurance Median: $948 (888%)

Cash: $1,638 (1534% of Medicare)

Ins. Median: $948 (888% 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 888% of the Medicare baseline (a markup of 788%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Alpha Care Medical Group	$135 - $203	126%
Dignity Health	$135 - $203	126%
Epic Health Plan	$135 - $1,896	126%
Inland Empire Health Plan (Iehp)	$135 - $214	126%
Kaiser Foundation Hospitals	$135 - $3,162	126%
Upland Medical Group	$135	126%
Vantage Medical Group	$135 - $203	126%
Molina Healthcare Of Ca	$170 - $181	159%
Heritage Provider Network	$222	208%
UnitedHealthcare	$491	460%
Adventist Health	$508 - $948	476%
Lluh Dept Of Risk Management	$610 - $1,138	571%
Blue Shield Of California	$1,027 - $1,555	962%
Global Benefits Group	$1,525 - $2,844	1428%
Temecula Valley Physicians Medical Group	$1,525	1428%
Trivalley Medical Group	$1,525	1428%
Blue Cross Blue Shield	$1,560	1461%
Cigna	$1,626 - $1,880	1522%
Networks By Design	$1,652 - $3,081	1547%
Multiplan	$2,033 - $3,792	1903%
Galaxy Health	$2,160 - $4,029	2022%
Prime Health Services	$2,160 - $4,029	2022%
Aetna	$2,754	2578%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,638.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72192.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Loma Linda University Children's Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72192.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.