CMS Price Transparency Data

X-ray, pelvis

Facility: Mayers Memorial Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $169
Cash Discount Price: $212
vs. Medicare Baseline: 1.58x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Mayers Memorial Hospital is $169. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $212. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.58x the Medicare baseline. Located in 43563 Hwy 299 East, Fall River Mills, CA.

Cash / Self-Pay

$212

Average discount available for prompt cash payment at this facility.

Insurance Median

$169

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: $212 (198%)

Insurance Median: $169 (158%)

Cash: $212 (198% of Medicare)

Ins. Median: $169 (158% 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 Shield Ca Va	$8 - $155	7%
Blue Shield Mcr Adv	$8 - $155	7%
Tricare	$8 - $163	7%
Arcadian Health Services-All Plans	$9 - $163	8%
Health Net Mcr Adv	$9 - $163	8%
Imperial Health Plan-All Plans	$10 - $184	9%
Medi-Cal	$22 - $31	21%
Partnership Hp-All Plans	$124	116%
Blue Cross Blue Shield	$165 - $211	154%
Cigna	$169 - $235	158%
Corvel Ppo-All Plans	$169 - $235	158%
Coventry/First Health-All Plans	$169 - $235	158%
Integrated Hp-All Plans	$169 - $235	158%
Interplan-All Plans	$169 - $235	158%
Health Net Prison	$178	167%
Blue Shield Ca Exchange	$211	198%
Blue Shield-All Other Plans	$235	220%
Hmn-All Plans	$235	220%
Multiplan Phcs-All Plans	$235	220%
Pfmc-All Plans	$235	220%
Superior Ca-All Plans	$235	220%
Health Net-All Other Plans	$246	230%
Pacificare-All Plans	$247	231%

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 $212.
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 Mayers Memorial 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.