CMS Price Transparency Data

Trauma team activation

Facility: St Lukes Regional Medical Center

Billing Code: G0390 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0390
Insurance Median: $1,320
Cash Discount Price: $1,679
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Trauma team activation at St Lukes Regional Medical Center is $1,320. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,679. Compared to the federal Medicare reimbursement reference rate of $1,361.78, this hospital’s rate is 0.97x the Medicare baseline. Located in 2720 Stone Park Boulevard, Sioux City, IA.

Cash / Self-Pay

$1,679

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,320

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$1,361.78

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $1,361.78 (100%)

Cash / Self-Pay: $1,679 (123%)

Insurance Median: $1,320 (97%)

Cash: $1,679 (123% of Medicare)

Ins. Median: $1,320 (97% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $1,361.78 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.

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
Nebraska Total Care	$546	40%
Medica Exchange Inspire	$1,083	80%
Iowa Total Care	$1,172	86%
Amerigroup	$1,172	86%
Medica Exchange Insure	$1,213	89%
Blue Cross Blue Shield	$1,315	97%
Aetna	$1,315 - $3,235	97%
Molina	$1,315	97%
Cigna	$1,320	97%
Humana	$1,354	99%
Amerivantage	$1,354	99%
UnitedHealthcare	$1,354 - $3,532	99%
Avera Health Plan	$1,364	100%
Health Partners Open Network	$1,976	145%

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 $1,679.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0390.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Lukes Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0390.
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.