CMS Price Transparency Data

CT scan, pelvis

Facility: Valley Children's Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,938
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 18.14x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Valley Children's Hospital is $1,938. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 18.14x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,938

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%)
Insurance Median: $1,938 (1814%)
Ins. Median: $1,938 (1814% 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 1814% of the Medicare baseline (a markup of 1714%). 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
UnitedHealthcare $331 - $844 310%
Allcare Ipa $334 313%
Kaiser $337 - $2,399 316%
Dignity Ipa_Formerly Img $467 437%
La Salle Ipa $467 437%
Sante Ipa $467 437%
Central Valley Medical Providers Ipa $501 - $1,846 469%
Sequoia Health Ipa $501 469%
Univseral Healthcare Ipa $501 469%
United Physicians Network Ipa $517 484%
Community Care Ipa $527 493%
Adventist $589 551%
Blue Cross Blue Shield $605 - $2,360 566%
Cencal Health $660 618%
Kern Family Health Care $667 624%
Central California Alliance For Health $679 636%
Health Net $1,299 - $2,417 1216%
Dignity Health Central Coast $1,829 1712%
Community Health $2,030 1901%
Stanislaus Partners In Health $2,030 1901%
Physicians Choice Medical Group $2,067 1935%
Health Plan Of San Joaquin $2,215 2074%
Fowler Packing $2,288 2142%
Dignity (Formerly Managed Care Systems) $2,325 2177%
Kern Legacy $2,399 2246%
Blue Shield $2,465 - $2,800 2308%
Aetna $2,473 2315%
First Health Formerly Coventry $2,731 2557%
Bakersfield Family Medical Group $2,768 2592%
Network By Design $2,861 2679%
Community Care Health Plan $2,952 2764%
Health Smart $2,953 2765%
Key Medical Ipa $2,953 2765%
Sutter Health $3,137 2937%
Multiplan $3,531 3306%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens