CMS Price Transparency Data
X-ray, pelvis
Facility: Adventist Health White Memorial
Billing Code: 72170 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72170
- Insurance Median: $134
- Cash Discount Price: $191
- vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Adventist Health White Memorial is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $191. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.25x the Medicare baseline. Located in 1720 Cesar E Chavez Avenue, Los Angeles, CA.
Cash / Self-Pay
$191
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: $191 (179%)
Insurance Median: $134 (125%)
Cash: $191 (179% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bc Medi-Cal | $14 | 13% |
| Access Medi-Cal | $31 | 29% |
| Ahp Medi-Cal | $31 | 29% |
| Alta Los Angeles Mcal 1/1/19 | $31 | 29% |
| Avanti Mcal | $31 | 29% |
| Bella Vista Medi-Cal Op/Profee Only | $31 | 29% |
| Healthcare Inc Medi-Cal | $31 | 29% |
| Lasalle Mg Medi-Cal | $31 | 29% |
| Medi-Cal | $31 | 29% |
| Molina Medi-Cal | $31 | 29% |
| Pacific Alliance Medi-Cal | $31 | 29% |
| Pacific Ipa Medi-Cal | $31 | 29% |
| Preferred Ipa La Care Mcal Cap | $31 | 29% |
| Preferred Medi-Cal | $31 | 29% |
| Altamed Medi-Cal - All Other Plans | $36 | 34% |
| Fcs Ipa Medi-Cal Op/Profee Only | $37 | 35% |
| Healthnet Mcal | $37 | 35% |
| Preferred Healthy | $39 | 37% |
| Assoc Hispanic Physcns Mcal | $43 | 40% |
| Blue Shield Medi-Cal | $78 | 73% |
| Aetna | $82 | 77% |
| Blue Shield Mcr Adv | $85 | 80% |
| Care First Medi-Cal | $109 | 102% |
| Access Group | $114 | 107% |
| Ahp - All Other Plans | $114 | 107% |
| Lasalle Mg Commercial - All Other Plans | $114 | 107% |
| Blue Cross Blue Shield | $125 - $166 | 117% |
| Access Senior - All Other Plans | $134 | 125% |
| Ahp Senior | $134 | 125% |
| Alta Los Angeles Mcr 1/1/19-All Other Plans | $134 | 125% |
| Altamed Connect | $134 | 125% |
| Avanti Mcr Adv - All Other Plans | $134 | 125% |
| Brand New Day Mcare - All Plans | $134 | 125% |
| Bs Va Mcare | $134 | 125% |
| Care First Mcare - All Other Plans | $134 | 125% |
| Clever Care - All Plans | $134 | 125% |
| Fcs Ipa Mcr Advan Op/Profee Only | $134 | 125% |
| Humana | $134 | 125% |
| Lasalle Mg Senior | $134 | 125% |
| Medicare (plans) | $134 | 125% |
| Molina Mcare | $134 | 125% |
| Pacific Alliance Mcare - All Other Plans | $134 | 125% |
| Preferred Senior | $134 | 125% |
| Sunlight Living Hlth Mcr Adv-All Other Plans | $134 | 125% |
| Tricare | $134 | 125% |
| UnitedHealthcare | $134 - $532 | 125% |
| Fcs Ipa Op/Profee Only - All Other Plans | $141 | 132% |
| Bright Health - All Plans | $155 | 145% |
| Assoc Hispanic Physcns Hmo/Mcr Adv-All Other Plans | $161 | 151% |
| Preferred Commercial - All Other Plans | $161 | 151% |
| Intergrated Medical - All Plans | $175 | 164% |
| Molina Benefit Exchange - All Other Plans | $182 | 170% |
| Php-Prospect Health Plan Cap - All Plans | $202 | 189% |
| Ah Employee Health Plan - All Plans | $242 | 227% |
| Blue Shield Epn | $253 | 237% |
| Blue Shield - All Other Plans | $294 | 275% |
| Centivo - All Plans | $303 | 284% |
| Pacific Ipa - All Other Plans | $404 | 378% |
| Kaiser- All Plans | $436 | 408% |
| Western Growers/Pinnacle - All Plans | $436 | 408% |
| Healthnet - All Other Plans | $481 | 450% |
| Healthnet Comm Care | $496 | 464% |
| Caremore Mcare - All Plans | $532 | 498% |
| Hcpamg - All Plans | $533 | 499% |
| Healthcare Inc - All Other Plans | $585 | 548% |
| La Care Mcr Adv - All Plans | $585 | 548% |
| First Heatlh Ppo - All Plans | $617 | 578% |
| Phcs Ppo - All Plans | $691 | 647% |
| Scan Health Mcare - All Plans | $691 | 647% |
| Cigna | $696 | 652% |
| Ahf - All Plans | $797 | 746% |
| Beech Street - All Plans | $797 | 746% |
| Interplan Ppo - All Plans | $797 | 746% |
| Corvel Corp - All Plans | $850 | 796% |
| Multiplan Ppo - All Plans | $882 | 826% |
| Healthmannet - All Plans | $904 | 846% |
| Next Inc Ppo - All Plans | $904 | 846% |
| Trpn - All Plans | $904 | 846% |
| Bella Vista Mcr Adv Op/Profee Only - All Other Pla | $957 | 896% |
| Fpn Ppo - All Plans | $957 | 896% |
| Healthnet Mcr Adv | $1,626 | 1522% |