CMS Price Transparency Data

X-ray, pelvis

Facility: San Gorgonio Memorial Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $134
  • Cash Discount Price: $161
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at San Gorgonio Memorial Hospital is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $161. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.25x the Medicare baseline. Located in 600 North Highland Springs Avenue, Banning, CA.
Cash / Self-Pay
$161

Average discount available for prompt cash payment at this facility.

Insurance Median
$134

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: $161 (151%)
Insurance Median: $134 (125%)
Cash: $161 (151% of Medicare)
Ins. Median: $134 (125% 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.

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
Lasalle Medical Associates $127 119%
Beaver Medical Group $134 125%
Blue Cross Blue Shield $134 125%
Blue Shield $134 125%
Choice Physicians Network $134 125%
Heritage Provider Network $134 125%
Inland Empire Health Plan $134 - $147 125%
Kaiser $134 - $401 125%
Providence Health Network $134 125%
Redlands Community Hospital $134 - $154 125%
UnitedHealthcare $134 125%
Easy Choice Health Plan $140 131%
Epic Management $140 131%
Velocity $147 138%
Imperial Health Plan $151 141%
Health Net $171 - $192 160%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 North Highland Springs Avenue, Banning, CA 92220
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals