CMS Price Transparency Data

CT scan, pelvis

Facility: Adventist Health Howard Memorial

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $883
Cash Discount Price: $522
vs. Medicare Baseline: 8.27x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Adventist Health Howard Memorial is $883. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $522. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.27x the Medicare baseline. Located in 1 Marcela Dr, Willits, CA.

Cash / Self-Pay

$522

Average discount available for prompt cash payment at this facility.

Insurance Median

$883

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: $522 (489%)

Insurance Median: $883 (827%)

Cash: $522 (489% of Medicare)

Ins. Median: $883 (827% 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 827% of the Medicare baseline (a markup of 727%). 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
Cigna	$29 - $3,715	27%
Blue Shield Mcare	$51 - $874	48%
Medicare (plans)	$51 - $883	48%
Tricare	$51 - $874	48%
UnitedHealthcare	$51 - $3,382	48%
Ah Employee Health Plan - All Plans	$56 - $2,273	52%
Healthnet - All Plans	$74 - $3,584	69%
Western Growers/Pinnacle - All Plans	$77 - $3,278	72%
Brms - All Plans	$86 - $3,715	81%
Blue Shield - All Other Plans	$99 - $2,312	93%
Medi-Cal	$101 - $205	95%
Aetna	$174 - $2,932	163%
Blue Cross Blue Shield	$941 - $1,129	881%
Blue Shield Epn	$2,317	2169%
First Health Ppo - All Plans	$2,622 - $3,497	2455%
Ghn Ppo - All Plans	$2,622 - $3,497	2455%

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 $522.
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 Adventist Health Howard Memorial 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.