CMS Price Transparency Data

CT scan, pelvis

Facility: Casa Colina Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $161
  • Cash Discount Price: $175
  • vs. Medicare Baseline: 1.51x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Casa Colina Hospital is $161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $175. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.51x the Medicare baseline. Located in 255 E Bonita Ave, Pomona, CA.
Cash / Self-Pay
$175

Average discount available for prompt cash payment at this facility.

Insurance Median
$161

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: $175 (164%)
Insurance Median: $161 (151%)
Cash: $175 (164% of Medicare)
Ins. Median: $161 (151% 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
Heritage Prvdr Ntwrk Mcal $108 101%
Prospect Hp Mcal $121 113%
Heritage Prvdr Ntwrk Comm - All Other Plans $128 - $267 120%
Heritage Prvdr Ntwrk Mcr $128 - $267 120%
Promed Hlth Ntwrk Op Only - All Plans $128 120%
Healthnet Comm - All Other Plans $131 - $273 123%
Aetna $134 - $333 125%
Blue Cross Blue Shield $134 - $391 125%
Blue Shield Mcr Adv $134 125%
Caremore Mcr Adv - All Plans $134 125%
Central Hlth Plan - All Plans $134 125%
Doctors Managed Op Only - All Plans $134 125%
Empire Healthcare Op Only - All Plans $134 125%
Focus Healthcare Wc - All Plans $134 125%
Healthnet Mcr Adv $134 125%
Humana $134 - $333 125%
Iehp - All Other Plans $134 125%
Iehp Mcr Adv $134 125%
Kaiser Comm - All Other Plans $134 125%
Kaiser Mcr Adv $134 125%
Premiercare Op Only - All Plans $134 125%
Prospect Hp Mcr Adv $134 125%
Triwest - All Plans $134 125%
UnitedHealthcare $134 - $333 125%
Wellcare Mcr Adv - All Plans $134 125%
Prospect Hp Comm - All Other Plans $148 139%
Corvel - All Plans $160 - $333 150%
Coventry - All Plans $160 - $333 150%
Multiplan - All Plans $160 - $333 150%
Three Rivers - All Plans $160 - $333 150%
Affiliated Hlth Funds - All Plans $168 157%
Cigna $179 - $373 168%
Brand New Day Mcr Adv - All Plans $192 - $400 180%
Medi-Cal $205 192%
Galaxy Provdr Ntwrk - All Plans $224 - $467 210%
Kaiser Mcal $225 211%
Blue Shield Comm - All Other Plans $237 - $493 222%
Prospect Med Grp Alta - All Plans $273 - $567 256%
Iehp Mcal $321 - $512 301%
Epic Comm - All Other Plans $400 374%
Epic Mcr Adv $400 374%
Healthcare Partners - All Other Plans $400 374%
Healthcare Partners Mcr $400 374%
Primecare Comm - All Other Plans $400 374%
Primecare Mcr Adv $400 374%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 255 E Bonita Ave, Pomona, CA 91767
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals