CMS Price Transparency Data
X-ray, pelvis
Facility: Scripps Mercy Hospital
Billing Code: 72170 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72170
- Insurance Median: $145
- Cash Discount Price: $119
- vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Scripps Mercy Hospital is $145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.36x the Medicare baseline. Located in 4077 5Th Ave, San Diego, CA.
Cash / Self-Pay
$119
Average discount available for prompt cash payment at this facility.
Insurance Median
$145
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: $119 (111%)
Insurance Median: $145 (136%)
Cash: $119 (111% of Medicare)
Ins. Median: $145 (136% 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 |
|---|---|---|
| Aetna | $23 - $263 | 22% |
| UnitedHealthcare | $23 - $183 | 22% |
| Radys Cpmg [803] | $34 - $42 | 32% |
| Blue Cross Blue Shield | $69 - $138 | 65% |
| Cigna | $69 - $206 | 65% |
| Mc Alignment [917] | $69 - $83 | 65% |
| Mc Blue Shield Promise Health Plan [914] | $69 - $83 | 65% |
| Mc Blue Shield [902] | $69 - $83 | 65% |
| Mc Health Net [904] | $69 - $83 | 65% |
| Mc Scan [905] | $69 - $83 | 65% |
| Mc United [906] | $69 - $83 | 65% |
| Bc [814] | $95 - $115 | 89% |
| Imperial County Phys Med Group [855] | $95 - $178 | 89% |
| Integrated Health Partners [894] | $95 - $115 | 89% |
| Perlman Med Group [899] | $95 - $115 | 89% |
| Sharp Comm Med Grp [812] | $95 - $237 | 89% |
| Sharp Rees Stealy Med Grp [811] | $95 - $237 | 89% |
| Ucsd [807] | $95 - $237 | 89% |
| Centivo [581] | $99 - $120 | 93% |
| Astiva Mcr Adv [464] | $134 | 125% |
| Bc Mcr Adv [830] | $134 | 125% |
| Bs Mcr Adv [829] | $134 | 125% |
| Central Health Mcr Adv [441] | $134 | 125% |
| Clever Care Mcr Adv [465] | $134 | 125% |
| D-Snp Mcr Adv [889] | $134 | 125% |
| Dsnp/Csnp - Generic [458] | $134 | 125% |
| Family Health Centers Pace Mcr Adv Hmo [556] | $134 | 125% |
| Family Health Centers Pace Medi-Cal [555] | $134 | 125% |
| Gary And Mary West Pace Medi-Cal Hmo [557] | $134 | 125% |
| Gpmg/Altura - Mcr Adv [888] | $134 | 125% |
| Hn Mcr Adv [832] | $134 | 125% |
| Humana | $134 | 125% |
| Integrated Health Partners - Mcr Adv [895] | $134 | 125% |
| Kaiser Northern Ca Region Mcr Adv [386] | $134 | 125% |
| La Care Mcr Adv Hmo [612] | $134 | 125% |
| Medicare (plans) | $134 | 125% |
| Mpmg Mcr Adv [836] | $134 | 125% |
| Mpmg [800] | $134 | 125% |
| Ocn Mcr Adv [890] | $134 | 125% |
| San Diego Pace Medi-Cal [553] | $134 | 125% |
| Scan Mcr Adv [835] | $134 | 125% |
| Scan [500] | $134 | 125% |
| Scan [818] | $134 | 125% |
| Sharp Comm Med Grp Mcr Adv [840] | $134 | 125% |
| Sharp Health Plan Mcr Adv [531] | $134 | 125% |
| Sharp Health Plan Mcr Adv [897] | $134 | 125% |
| Sharp Rees Stealy Med Grp Mcr Adv [841] | $134 | 125% |
| St Paul'S Pace Medi-Cal [551] | $134 | 125% |
| Ucsd Mcr Adv [873] | $134 | 125% |
| Uh Mcr Adv [831] | $134 | 125% |
| Uh Palomar Health Mcr Adv [885] | $134 | 125% |
| Alignment Health Plan [443] | $138 | 129% |
| Blue Shield [230] | $142 - $187 | 133% |
| Health Net [340] | $145 - $336 | 136% |
| Hn [815] | $145 - $175 | 136% |
| Bs [816] | $147 - $185 | 138% |
| Uh [819] | $151 - $183 | 141% |
| Kaiser Northern Ca Region Hmo/Ppo [384] | $161 - $196 | 151% |
| Kaiser [380] | $161 - $196 | 151% |
| Kaiser [383] | $161 - $196 | 151% |
| Rady Children'S Hospital [825] | $176 - $214 | 165% |
| Palomar Health [892] | $195 - $237 | 183% |
| Veba Med Grp [813] | $195 - $237 | 183% |
| Prime Healthcare [614] | $229 | 214% |
| Prospect Med Group [893] | $235 | 220% |
| Multi Plan Network [470] | $305 - $370 | 286% |
| First Health Network [330] | $323 - $391 | 302% |
| Pnoa [615] | $323 - $391 | 302% |
| Choice Care Network [270] | $344 - $417 | 322% |
| Healthsmart [350] | $344 - $417 | 322% |