CMS Price Transparency Data

X-ray, pelvis

Facility: University of California Davis Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $22
Cash Discount Price: $354
vs. Medicare Baseline: 0.21x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at University of California Davis Medical Center is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $354. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.21x the Medicare baseline. Located in 2315 Stockton Boulevard, Sacramento, CA.

Cash / Self-Pay

$354

Average discount available for prompt cash payment at this facility.

Insurance Median

$22

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: $354 (331%)

Insurance Median: $22 (21%)

Cash: $354 (331% of Medicare)

Ins. Median: $22 (21% 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
Adventist	$8 - $30	7%
Generic	$8 - $30	7%
Healthnet	$8 - $415	7%
Blue Cross Blue Shield	$22 - $136	21%
Carpenters H&W	$22	21%
Cement Masons Trust Fund	$22	21%
Delta	$22	21%
Healthcomp	$22	21%
Ironworkers	$22	21%
Joint Benefit Trust	$22	21%
Laborers Health And Welfare	$22	21%
Operating Engrs Health Welfare	$22	21%
Sierra Pacific Industries	$22	21%
Western Growers	$22	21%
Dignity/Chw	$23	22%
UnitedHealthcare	$141 - $726	132%
Blue Shield Senior	$142	133%
Healthnet Senior	$144	135%
San Joaquin Health Plan Gmc	$149	140%

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 $354.
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 University of California Davis 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.