CMS Price Transparency Data

Trauma team activation

Facility: Teton Valley Hospital

Billing Code: G0390 (HCPCS)

The BaseRate · fair price medium confidence
A fair price for this
$712
about 0.5× the $1,362 Medicare rate · typically $222–$1,167
modeled estimate · not a bill or quote
Medicare pays $1,362 Fair price $712 Cash price $977 Hospital's list price $1,222

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.

5 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 $551 - $1,183 40%
Blue Cross Blue Shieldmajor $456 - $1,220 33%
Aetnamajor $563 - $1,158 41%
Cignamajor $1,138 - $1,183 84%
Humanamajor $563 - $585 41%
Moda Health $1,078 - $1,120 79%
SelectHealth $1,138 - $1,183 84%
+ 1 smaller / regional plan $1,078 - $1,120
Government programs also on file: Medicare, Military & VA.
Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 120 East Howard Ave, Driggs, ID 83422
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals