CMS Price Transparency Data

CT scan, pelvis

Facility: Adventist Health Portland

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $429
  • Cash Discount Price: $749
  • vs. Medicare Baseline: 4.02x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Adventist Health Portland is $429. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $749. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.02x the Medicare baseline. Located in 10123 Se Market Street, Portland, OR.
Cash / Self-Pay
$749

Average discount available for prompt cash payment at this facility.

Insurance Median
$429

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: $749 (701%)
Insurance Median: $429 (402%)
Cash: $749 (701% of Medicare)
Ins. Median: $429 (402% 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 402% of the Medicare baseline (a markup of 302%). 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
Ods - All Plans $93 87%
Care Oregon - All Plans $99 93%
Kaiser Mcr Adv $116 109%
Humana $119 - $123 111%
Moda Mcr Adv $123 115%
UnitedHealthcare $123 - $1,405 115%
Healthnet Mcr Adv $134 125%
Pacific Source Comm - All Plans $146 137%
Ah Employee Health Plan - All Plans $209 196%
Moda Conn Oebb/Syn Pebb $232 217%
Regence Ohsu Plus $260 243%
Moda Affinity - All Other Plans $267 250%
Regence - All Other Plans $289 271%
Kaiser - All Other Plans $303 284%
Moda Select $364 341%
Moda Connexus $411 385%
Providence Hp - All Plans $429 402%
Moda Synergy $435 407%
Regence Preferred Mcr Adv $519 486%
Healthcare Resources - All Plans $526 492%
Regence Mcr Adv $656 614%
Workers Comp $810 758%
Bc Premera First - All Plans $1,171 1096%
Worldventure - All Plans $1,405 1315%
Cigna $1,600 1498%
First Choice - All Plans $1,623 1520%
Multiplan - All Plans $1,756 1644%
Phcs - All Plans $1,756 1644%
Aetna $1,831 1714%
First Health-Coventry - All Plans $1,874 1755%
National Provider Network - All Plans $2,061 1930%
Health Payors Organization Ltd- All Plans $2,108 1974%
Moda Ohsu Ppo/Epo/Hmc $4,216 3947%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10123 Se Market Street, Portland, OR 97216
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals