CMS Price Transparency Data

X-ray, pelvis

Facility: Adventist Health Lodi Memorial

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $34
  • Cash Discount Price: $21
  • vs. Medicare Baseline: 0.32x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Adventist Health Lodi Memorial is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.32x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.
Cash / Self-Pay
$21

Average discount available for prompt cash payment at this facility.

Insurance Median
$34

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: $21 (20%)
Insurance Median: $34 (32%)
Cash: $21 (20% of Medicare)
Ins. Median: $34 (32% 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
Ah Employee Health Plan - All Plans $9 - $248 8%
Alignment Health Plan (Ahp)-All Plans $9 - $138 8%
Blue Shield Mcare Adv $9 - $138 8%
Healthnet Mcare $9 - $138 8%
Hp Healthy Kids Pro Fee $9 8%
Hp Of San Joaquin Mcr Adv $9 - $138 8%
Humana $9 - $138 8%
Knnex Health - All Plans $9 - $165 8%
Medcore(Omni Ipa) Op Only- All Plans $9 - $341 8%
Tricare $9 - $138 8%
UnitedHealthcare $9 - $544 8%
Cigna $10 - $1,179 9%
First Health- All Plans $10 - $1,074 9%
Beech Street- All Plans $11 - $1,179 10%
Blue Shield Epn - All Other Plans $11 - $424 10%
Blue Shield Non-Epn $11 - $440 10%
Hp Of San Joaquin Ppo - All Other Plans $11 - $1,244 10%
Multiplan- All Plans $11 - $1,048 10%
Healthnet- All Other Plans $12 - $643 11%
Kaiser Commercial - All Other Plans $12 - $537 11%
Kaiser Mcr Adv $12 - $138 11%
Networks By Design- All Plans $12 - $655 11%
Western Growers- All Plans $13 - $1,179 12%
Bc Mcal $15 - $22 14%
Blue Cross Blue Shield $15 - $164 14%
Celtic Ins Company - All Plans $22 - $35 21%
Kaiser Mcal $22 - $31 21%
Medi-Cal $22 - $31 21%
Hp Mcal Pro Fee $24 22%
Aetna $26 - $212 24%
Healthnet Mcal $26 - $44 24%
Hp Of San Joaquin Mcal $26 - $39 24%
Three Rivers Provider Network- All Plans $30 - $1,179 28%
Cca Health Plan Mcr Adv- All Plans $138 129%
Bright Health - All Plans $276 258%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 S Fairmont Avenue, Lodi, CA 95240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals