CMS Price Transparency Data

CT scan, pelvis

Facility: Adventist Health Clearlake

Billing Code: 72192 (CPT)

The BaseRate · fair price low confidence
A fair price for this
$1,038
about 9.7× the $107 Medicare rate · typically $197–$1,715
modeled estimate · not a bill or quote
Medicare pays $107 Fair price $1,038 Cash price $1,736 Hospital's list price $4,823

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $1,037 - $4,298 971%
Blue Cross Blue Shieldmajor $873 - $2,288 817%
Aetnamajor $3,356 - $3,851 3142%
Cignamajor $4,042 - $4,639 3784%
Humanamajor $3,817 - $4,381 3574%
Kaiser Permanentemajor $943 - $4,639 883%
Health Net $3,683 - $4,226 3448%
+ 6 smaller / regional plans $205 - $8,504
Government programs also on file: Medicaid, Military & VA.
Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 15630 18Th Ave - Hwy 53, Clearlake, CA 95422
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals