CMS Price Transparency Data

X-ray, pelvis

Facility: Chinese Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $152
Cash Discount Price: $674
vs. Medicare Baseline: 1.42x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Chinese Hospital is $152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $674. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.42x the Medicare baseline. Located in 845 Jackson St, San Francisco, CA.

Cash / Self-Pay

$674

Average discount available for prompt cash payment at this facility.

Insurance Median

$152

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: $674 (631%)

Insurance Median: $152 (142%)

Cash: $674 (631% of Medicare)

Ins. Median: $152 (142% 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.

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
Blue Cross Blue Shield	$31 - $212	29%
Medi-Cal	$31	29%
San Francisco Health Plan- All Plans	$31	29%
Hp Of San Mateo Medi-Cal	$38	36%
Hp Of San Mateo Health Kids/Health Worx-All Other	$41	38%
Blue Shield Medi-Cal	$42	39%
Asian Medical Group Medi-Cal Op Only	$43	40%
Jade Medi-Cal	$56	52%
Aetna	$124 - $151	116%
Cchp Mcr Adv	$151	141%
Jade Mcr Adv	$151	141%
Jade-All Other Plans	$166	155%
On Lok Mcr Adv-All Plans	$166	155%
Blue Shield - All Other Plans	$261	244%
Health Net-All Plans	$357	334%
Cigna	$371	347%
Cchp-All Other Plans	$573	536%
Hp Of San Mateo Mcr Adv	$607	568%
Asian Medical Group Mcare Op Only-All Other Plans	$674	631%
Bay Area Accountable Care Mcare	$674	631%
Bay Area Accountable Care - All Other Plans	$1,213	1136%

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 $674.
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 Chinese Hospital 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.