CMS Price Transparency Data

X-ray, pelvis

Facility: Banner-University Medical Center South Campus

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $113
Cash Discount Price: $133
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Banner-University Medical Center South Campus is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $133. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.06x the Medicare baseline. Located in 2800 East Ajo Way, Tucson, AZ.

Cash / Self-Pay

$133

Average discount available for prompt cash payment at this facility.

Insurance Median

$113

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: $133 (125%)

Insurance Median: $113 (106%)

Cash: $133 (125% of Medicare)

Ins. Median: $113 (106% 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.

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
Aetna	$38 - $249	36%
Blue Cross Blue Shield	$47 - $113	44%
Arizona Physicians Ipa	$79 - $113	74%
Banner University Health Plan	$79 - $113	74%
Health Choice Arizona, Inc.	$79 - $170	74%
Health Net	$79 - $168	74%
Mercy Care	$79 - $113	74%
Banner Health	$113	106%
Care 1St	$113	106%
Cigna	$113 - $266	106%
Gila River Health Care Corporation	$113	106%
Kaiser Foundation Health Plan	$113	106%
Triwest Healthcare Alliance Corp - Va Ccn	$113	106%
UnitedHealthcare	$113 - $552	106%
Upmc Health Plan	$113	106%
Wellpoint	$113	106%
Humana	$117	110%
Carelon	$119	111%
Devoted Health Services	$119	111%
Arizona Priority Care	$125	117%
Gold Kidney Health Plan	$125	117%
University Of Arizona (Kasser Medical Treatment Center)	$151	141%
Naphcare	$153	143%
Oscar Health Plan	$187	175%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi)	$194	182%
Plotkin Health	$194	182%
Quiktrip Corporation	$233	218%
Provider Network Of America	$324	303%
Arizona Medical Network	$346	324%

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 $133.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72170.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Banner-University Medical Center South Campus is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72170.
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.