CMS Price Transparency Data

Trauma team activation

Facility: Memorial Hospital of Carbon County

Billing Code: G0390 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0390
Insurance Median: $3,773
Cash Discount Price: $3,550
vs. Medicare Baseline: 2.77x Medicare

The contracted insurance negotiated median rate for a Trauma team activation at Memorial Hospital of Carbon County is $3,773. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,550. Compared to the federal Medicare reimbursement reference rate of $1,361.78, this hospital’s rate is 2.77x the Medicare baseline. Located in 2221 West Elm Street, Rawlins, WY.

Cash / Self-Pay

$3,550

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,773

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: $3,550 (261%)

Insurance Median: $3,773 (277%)

Cash: $3,550 (261% of Medicare)

Ins. Median: $3,773 (277% 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 277% of the Medicare baseline (a markup of 177%). 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
Blue Cross Blue Shield	$2,033 - $5,112	149%
Medicare (plans)	$2,033 - $2,890	149%
Vaccn	$2,033 - $2,890	149%
Three_River_Providers_Network	$2,932 - $4,168	215%
Wise_Provider_Networks	$2,932 - $4,168	215%
Zelis	$2,932 - $4,168	215%
Corechoice	$3,519 - $5,001	258%
First_Choice_Health	$3,519 - $5,001	258%
Cigna	$3,636 - $5,168	267%
UnitedHealthcare	$3,754 - $5,335	276%
Interwests_Ppo_Network	$3,793 - $5,390	279%
Multiplan	$3,793 - $5,390	279%
Medicaid / KanCare	$3,910 - $5,557	287%

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 $3,550.
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 Memorial Hospital of Carbon County 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.