CMS Price Transparency Data

X-ray, pelvis

Facility: Adventist Health Tehachapi Valley

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $86
Cash Discount Price: $55
vs. Medicare Baseline: 0.81x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Adventist Health Tehachapi Valley is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.81x the Medicare baseline. Located in 1100 Magellan, Tehachapi, CA.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$86

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: $55 (51%)

Insurance Median: $86 (81%)

Cash: $55 (51% of Medicare)

Ins. Median: $86 (81% 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
Aetna	$9 - $91	8%
Ah Employee Health Plan - All Plans	$9 - $311	8%
Healthnet Mcare	$9 - $111	8%
Network Providers- All Plans	$9 - $143	8%
Tricare	$9 - $111	8%
UnitedHealthcare	$9 - $287	8%
Universal Ipa Mcr Adv Op/Profee Only-All Other Pla	$9 - $111	8%
Cigna	$10 - $458	9%
Coventry- All Plans	$10 - $527	9%
Oscar Health Plan- All Plans	$10 - $171	9%
Blue Shield Epn- All Other Plans	$12 - $248	11%
Healthnet- All Other Plans	$12 - $451	11%
Blue Shield Non-Epn	$13 - $293	12%
Centivo - All Plans	$13 - $251	12%
Western Grwrs/Pinnacle - All Plans	$13 - $246	12%
Medi-Cal	$22 - $31	21%
Universal Ipa Mcal Op/Profee Only	$22 - $31	21%
Kaiser Medi-Cal Ip/Op Only	$31	29%
Bc Mcal	$32	30%
Healthnet Medi-Cal	$38	36%
Medicare (plans)	$39 - $111	37%
Khs-Kern Hlth Systm Mcal	$40	37%
Kaiser Ip/Op Only- All Other Plans	$67 - $192	63%
Klhp-Kern Legacy Epo -All Other Plans	$102 - $293	95%
Blue Cross Blue Shield	$106 - $338	99%

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 $55.
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 Adventist Health Tehachapi Valley 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.