CMS Price Transparency Data

X-ray, pelvis

Facility: San Antonio Regional Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $289
  • Cash Discount Price: $281
  • vs. Medicare Baseline: 2.71x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at San Antonio Regional Hospital is $289. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $281. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.71x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$281

Average discount available for prompt cash payment at this facility.

Insurance Median
$289

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: $281 (263%)
Insurance Median: $289 (271%)
Cash: $281 (263% of Medicare)
Ins. Median: $289 (271% 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 271% of the Medicare baseline (a markup of 171%). 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
Medi-Cal $31 29%
Healthnet Medi-Cal $33 31%
Kaiser Medi-Cal $33 31%
Alpha Care Mg Mcal/Hlthy Kids $34 32%
Heritage Prov Ntwrk/Regal Mcal $34 32%
Molina Medi-Cal $36 34%
Blue Cross Blue Shield $37 - $615 35%
Aetna $39 - $1,132 37%
Iehp Mcal $40 37%
Blue Shield Epn $98 92%
Tricare $132 124%
Blue Shield Mcr Adv $134 125%
Caremore Mcr Adv - All Plans $134 125%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $134 125%
Healthnet Mcr Adv $134 125%
Humana $134 125%
Iehp Mcr Adv $134 125%
Inter Valley Hp Mcr Adv- All Plans $134 125%
Kindred Mcr Adv-All Plans $134 125%
Molina Mcr Adv $134 125%
Scan Health Plan Mcr Adv-All Plans $134 125%
Universal Care - All Plans $134 125%
Zelis Mcr Adv $141 132%
Kasiser Mcr Adv $144 135%
Imperial Health Mcr Adv-All Plans $148 139%
Choice Phycn Ntwrk Op Only $168 157%
Molina Exchange-All Other Plans $175 164%
Iehp Comm - All Other Plans $195 183%
Redlands Employee $202 189%
Ambetter / Centene $206 193%
Redlands Hmo-All Other Plans $210 197%
Prime Health - All Plans $235 220%
UnitedHealthcare $272 - $430 255%
Healthnet - All Other Plans $322 301%
Epic Health Plan - All Other Plans $340 318%
Kaiser Comm - All Other Plans $375 351%
Blue Shield Hmo Pos / Calpers Ppo $409 383%
Blue Shield Epo Ppo - All Other Plans $439 411%
Pc Inland Valley Scan $566 530%
Pc Inland Valley-All Other Plans $566 530%
Coventry Ccn/First Hlth - All Plans $623 583%
Cigna $711 666%
Choicecare Ntwrk-All Plans $815 763%
Multiplan/Phcs - All Plans $815 763%
Networks By Design - All Plans $849 795%
Zelis Comm-All Other Plans $849 795%
Foundation Inland Epo-All Other Plans $906 848%
Foundation Inland Ppo $962 901%
Health Payors - All Plans $1,019 954%
Interplan - All Plans $1,019 954%
Wellcare/Easy Choice-All Plans $1,109 1038%
Alpha Care Mg Mcr Adv $1,132 1060%
Central Hlth Plan Mcr Adv-All Plans $1,132 1060%
Epic Health Plan Mcr Adv $1,132 1060%
Prospect Hp-All Plans $1,132 1060%
Providence Clevercare Mcr Adv $1,132 1060%
Heritage Prov Ntwrk/Regal Mcr Adv $1,149 1076%
Clever Care Mcr Adv - All Plans $1,189 1113%
La Salle Hp Mcr Adv-All Plans $1,189 1113%
Providence Oscar-All Other Plans $1,189 1113%
Alpha Care Mg-All Other Plans $1,415 1325%
Heritage Prov Ntwrk/Regal - All Other Plans $2,080 1947%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals