CMS Price Transparency Data

X-ray, pelvis

Facility: City of Hope National Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $257
Cash Discount Price: $343
vs. Medicare Baseline: 2.41x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at City of Hope National Medical Center is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $343. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.41x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$343

Average discount available for prompt cash payment at this facility.

Insurance Median

$257

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: $343 (321%)

Insurance Median: $257 (241%)

Cash: $343 (321% of Medicare)

Ins. Median: $257 (241% 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 241% of the Medicare baseline (a markup of 141%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Health Net	$16 - $332	15%
Cal Optima	$22 - $30	21%
Heritage Provider Network	$27 - $240	25%
Inland Empire	$28 - $274	26%
Prime Healthcare Keenan	$40 - $329	37%
Blue Cross Blue Shield	$149 - $240	140%
UnitedHealthcare	$192 - $380	180%
Blue Shield	$203 - $408	190%
Blue Shield Covca	$208	195%
Blue Shield Promise	$240	225%
Cencal	$274	257%
La Care Health	$274	257%
Kaiser	$308	288%
Aetna	$342	320%
Gold Coast	$342	320%
Molina	$342 - $445	320%
Facey	$377	353%
Healthcare Partners	$397	372%
St. Joseph Heritage	$411	385%
Primecare Medical Network	$445	417%
First Health	$527	493%
Cigna	$573	536%
Phcs Multiplan	$616	577%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $343.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72170.

Insurance In-Network Protection Plan

Contact your insurance company to confirm City of Hope National Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72170.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.