CMS Price Transparency Data

Trauma team activation

Facility: Intermountain Health Sanpete Valley Hospital

Billing Code: G0390 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0390
  • Insurance Median: $4,233
  • Cash Discount Price: $3,595
  • vs. Medicare Baseline: 3.11x Medicare
The contracted insurance negotiated median rate for a Trauma team activation at Intermountain Health Sanpete Valley Hospital is $4,233. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,595. Compared to the federal Medicare reimbursement reference rate of $1,361.78, this hospital’s rate is 3.11x the Medicare baseline. Located in 1100 South Medical Drive, Mount Pleasant, UT.
Cash / Self-Pay
$3,595

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,233

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: $3,595 (264%)
Insurance Median: $4,233 (311%)
Cash: $3,595 (264% of Medicare)
Ins. Median: $4,233 (311% 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 311% of the Medicare baseline (a markup of 211%). 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.

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
Molina $1,203 - $4,874 88%
Health Plan of Nevada $1,203 - $4,566 88%
Selecthealth $1,203 - $4,874 88%
UnitedHealthcare $1,337 - $4,874 98%
Aetna $1,337 - $4,925 98%
Health Partners of Nevada $1,337 - $1,539 98%
Blue Cross Blue Shield $1,337 - $4,874 98%
Humana $1,337 - $4,874 98%
Healthy U $1,337 - $4,566 98%
American Health $1,337 - $1,539 98%
Triwest $1,388 - $4,634 102%
Injury Care of Nevada $3,342 - $3,848 245%
Wcf Insurance $3,788 - $4,361 278%
Corporation of the President $3,788 - $4,361 278%
Byu Risk Management $3,788 - $4,361 278%
Corvel Corporation $3,788 - $4,361 278%
Wise Network $4,233 - $4,874 311%
Franklin County $4,233 - $4,874 311%
Cigna $4,233 - $4,874 311%
Byu Athletics $4,233 - $4,874 311%
Awh Connected $4,233 - $4,925 311%
Utah Tech $4,233 - $4,874 311%
Managed Care Admin $4,233 - $4,874 311%
Pehp $4,233 - $4,874 311%
Uofu $4,233 - $4,874 311%
Emi $4,233 - $4,874 311%
Springtide $4,233 - $4,874 311%
Prodegi Corp Benefit $4,233 - $4,874 311%
Motivhealth $4,233 - $4,874 311%
Global Excel $4,233 - $4,874 311%
Medcare International $4,233 - $4,874 311%
Tanner LLC $4,233 - $4,874 311%
Deseret Mutual $4,233 - $4,874 311%
Ifit $4,233 - $4,874 311%
Hygeia Corporation $4,233 - $4,874 311%
Health Utah $4,233 - $4,874 311%
Campbell Scientific $4,233 - $4,874 311%
Lw Miller $4,233 - $4,874 311%
Juniper Systems $4,233 - $4,874 311%
Emi Health $4,233 - $4,874 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 South Medical Drive, Mount Pleasant, UT 84647
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals