CMS Price Transparency Data

X-ray, pelvis

Facility: Sonoma Valley Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $600
  • Cash Discount Price: $672
  • vs. Medicare Baseline: 5.62x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Sonoma Valley Hospital is $600. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $672. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.62x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$672

Average discount available for prompt cash payment at this facility.

Insurance Median
$600

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: $672 (629%)
Insurance Median: $600 (562%)
Cash: $672 (629% of Medicare)
Ins. Median: $600 (562% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 562% of the Medicare baseline (a markup of 462%). 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
Aetna $20 19%
First Health(Coventry)-All Plans $20 19%
Medi-Cal $31 29%
Mcal Mgd Care (Php)-All Plans $51 48%
Partnership Healthplan-All Plans $109 102%
Tricare $141 132%
Blue Cross Blue Shield $144 - $630 135%
Bright Hlth/Brand New Day Mcr Adv $144 135%
Hospice Of Marin-All Plans $144 135%
St Joseph Heritage Hltcare Comm-All Other Plans $144 135%
Veterans Admin-All Plans $144 135%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $151 141%
Cdcr Prison-All Plans $173 162%
Three Rivers (Trpn)-All Plans $173 162%
Chp - Correctional Health Partners - All Plans $187 175%
Bright Hlth/Brand New Day - All Other Plands $194 182%
Wellpath - All Plans $201 188%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $259 242%
Canopy Health Solutions-All Other Plans $259 242%
Healthnet Hmo/Ppo-All Other Plans $336 315%
Blue Shield Ppo-All Plans $545 510%
UnitedHealthcare $576 539%
Kaiser-All Plans $624 584%
Integrated Health Plan-All Plans $710 665%
Champus-All Plans $768 719%
Cigna $768 719%
Networks By Design - All Plans $768 719%
Comm Care Network(Ccn)-All Plans $816 764%
Great West-One Health Plan Ppo/Pos-All Plans $816 764%
Phcs/Multiplan/Beech St-All Plans $816 764%
Interplan-All Plans $845 791%
Bps-All Plans $864 809%
Ppo Alliance-All Plans $864 809%
Pref Health Networl(Phn)-All Plans $864 809%
Meritage Medical Network Op Only Mcare $960 899%
Scan Mcare-All Plans $960 899%
St Joseph Heritage Hltcare Mcr Adv $960 899%
Correct Care Integ Health-All Plans $1,152 1079%
Employer Direct Healthcare-All Plans $1,152 1079%
Meritage Medical Network Op Only-All Other Plans $1,210 1133%
Creative Legal Services-All Plans $1,248 1168%
Canopy Op Only $1,728 1618%
Vnpn - All Plans $1,728 1618%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals