CMS Price Transparency Data

X-ray, pelvis

Facility: St Francis Hospital - Interquest

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $94
Cash Discount Price: $340
vs. Medicare Baseline: 0.88x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at St Francis Hospital - Interquest is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $340. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.88x the Medicare baseline. Located in 10860 New Allegiance Dr, Colorado Springs, CO.

Cash / Self-Pay

$340

Average discount available for prompt cash payment at this facility.

Insurance Median

$94

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: $340 (318%)

Insurance Median: $94 (88%)

Cash: $340 (318% of Medicare)

Ins. Median: $94 (88% 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	$20 - $100	19%
Blue Cross Blue Shield	$20 - $749	19%
Cigna	$20 - $127	19%
Devoted Health	$20	19%
Humana	$20	19%
Innovage	$20	19%
Kaiser	$20 - $387	19%
Medicare (plans)	$20	19%
Rocky Mountain Pace	$20	19%
UnitedHealthcare	$20 - $245	19%
Direct To Employer	$75 - $230	70%
Centura Employee Plan	$91	85%
Multiplan	$134 - $724	125%
United Colorado Doctor'S Plan	$245	229%

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 $340.
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 St Francis Hospital - Interquest 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.