CMS Price Transparency Data

Trauma team activation

Facility: Samaritan Lebanon Community Hospital

Billing Code: G0390 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0390
Insurance Median: $2,912
Cash Discount Price: $2,840
vs. Medicare Baseline: 2.14x Medicare

The contracted insurance negotiated median rate for a Trauma team activation at Samaritan Lebanon Community Hospital is $2,912. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,840. Compared to the federal Medicare reimbursement reference rate of $1,361.78, this hospital’s rate is 2.14x the Medicare baseline. Located in 525 N Santiam Highway, Lebanon, OR.

Cash / Self-Pay

$2,840

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,912

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: $2,840 (209%)

Insurance Median: $2,912 (214%)

Cash: $2,840 (209% of Medicare)

Ins. Median: $2,912 (214% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 214% of the Medicare baseline (a markup of 114%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Providence	$568 - $5,034	42%
Samaritan	$574 - $4,412	42%
Healthnet	$625 - $5,034	46%
Regence	$625 - $4,665	46%
Pacificsource	$637 - $4,499	47%
Devoted Health	$654 - $1,731	48%
Aetna	$1,862 - $4,930	137%
Cigna	$1,901 - $5,034	140%

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 $2,840.
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 Samaritan Lebanon Community Hospital 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.