CMS Price Transparency Data

Trauma team activation

Facility: Holy Cross Hospital - Salt Lake

Billing Code: G0390 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0390
Insurance Median: $3,782
Cash Discount Price: $2,992
vs. Medicare Baseline: 2.78x Medicare

The contracted insurance negotiated median rate for a Trauma team activation at Holy Cross Hospital - Salt Lake is $3,782. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,992. Compared to the federal Medicare reimbursement reference rate of $1,361.78, this hospital’s rate is 2.78x the Medicare baseline. Located in 1050 East South Temple, Salt Lake City, UT.

Cash / Self-Pay

$2,992

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,782

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: $2,992 (220%)

Insurance Median: $3,782 (278%)

Cash: $2,992 (220% of Medicare)

Ins. Median: $3,782 (278% 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 278% of the Medicare baseline (a markup of 178%). 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
Cigna	$956 - $12,397	70%
Blue Cross Blue Shield	$994 - $9,298	73%
Pehp	$1,141 - $15,496	84%
Molina	$1,147 - $6,654	84%
Aetna	$1,180 - $13,094	87%
UnitedHealthcare	$1,226 - $7,113	90%
Uuhp	$1,293 - $8,399	95%
Humana	$1,335	98%
Medicare (plans)	$1,335	98%
Centura Employee Plan	$1,336 - $7,748	98%
Rocky Mountain Health Plan	$1,362	100%
Medicaid / KanCare	$1,362	100%
Denver Health	$1,362	100%
Health Choice	$1,362	100%
Wise	$1,389 - $8,213	102%
Deseret Mutual Benefit Administrators	$1,640 - $9,515	120%
Employer Direct Healthcare	$1,675	123%
Select Health	$1,768 - $10,255	130%
Motivhealth	$1,770	130%
Multiplan	$1,844 - $14,102	135%
Emi Health	$2,672 - $15,496	196%

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 $2,992.
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 Holy Cross Hospital - Salt Lake 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.