CMS Price Transparency Data

CT scan, pelvis

Facility: Adventist Health Vallejo

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $3,496
  • Cash Discount Price: $954
  • vs. Medicare Baseline: 32.73x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Adventist Health Vallejo is $3,496. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $954. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 32.73x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.
Cash / Self-Pay
$954

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,496

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: $954 (893%)
Insurance Median: $3,496 (3273%)
Cash: $954 (893% of Medicare)
Ins. Median: $3,496 (3273% 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 3273% of the Medicare baseline (a markup of 3173%). 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.

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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 $28 - $7,120 26%
Blue Shield Mcr Adv $50 - $106 47%
Medicare (plans) $50 - $106 47%
Napa County Mcal Child $50 - $106 47%
Tricare $50 - $106 47%
Ah Employee Health Plan-All Plans $56 - $191 52%
Interplan-All Plans $61 - $5,450 57%
Kaiser-All Plans $61 - $7,476 57%
Blue Shield Non-Epn-All Other Plans $66 - $4,130 62%
UnitedHealthcare $68 - $5,674 64%
Aetna $73 - $1,243 68%
Western Growers-All Plans $75 - $4,717 70%
Phcs-All Plans $92 - $4,895 86%
Va Mcr-All Other Plans $106 99%
Medi-Cal $128 - $205 120%
Health Management Network-All Plans $143 - $7,565 134%
Three Rivers-All Plans $151 - $8,010 141%
Va Medi-Cal $205 192%
Blue Cross Blue Shield $1,004 - $1,205 940%
Healthnet-All Plans $1,060 992%
Blue Shield Behav Hlth $2,146 - $4,005 2009%
Blue Shield Epn $2,246 - $4,192 2103%
Choicecare-All Plans $3,338 - $6,230 3125%
Beech Street-All Plans $3,576 - $6,675 3348%
Galaxy Network-All Plans $4,291 - $8,010 4017%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 Oregon St, Vallejo, CA 94590
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Psychiatric