CMS Price Transparency Data

X-ray, pelvis

Facility: Valley Children's Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $280
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.62x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Valley Children's Hospital is $280. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.62x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$280

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%)
Insurance Median: $280 (262%)
Ins. Median: $280 (262% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 262% of the Medicare baseline (a markup of 162%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Allcare Ipa $31 29%
Kaiser $31 - $328 29%
Dignity Ipa_Formerly Img $43 40%
La Salle Ipa $43 40%
Sante Ipa $43 40%
Central Valley Medical Providers Ipa $47 - $252 44%
Sequoia Health Ipa $47 44%
Univseral Healthcare Ipa $47 44%
United Physicians Network Ipa $48 45%
Community Care Ipa $49 46%
Adventist $55 51%
Blue Cross Blue Shield $56 - $286 52%
Cencal Health $61 57%
Kern Family Health Care $62 58%
Central California Alliance For Health $63 59%
Health Net $177 - $330 166%
Dignity Health Central Coast $250 234%
Community Health $277 259%
Stanislaus Partners In Health $277 259%
Physicians Choice Medical Group $282 264%
Health Plan Of San Joaquin $302 283%
Fowler Packing $312 292%
Dignity (Formerly Managed Care Systems) $318 298%
Kern Legacy $328 307%
UnitedHealthcare $331 310%
Blue Shield $337 - $382 316%
Aetna $338 316%
First Health Formerly Coventry $373 349%
Bakersfield Family Medical Group $378 354%
Network By Design $391 366%
Community Care Health Plan $403 377%
Health Smart $403 377%
Key Medical Ipa $403 377%
Sutter Health $428 401%
Multiplan $482 451%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens