CMS Price Transparency Data

X-ray, pelvis

Facility: Nemours Children's Hospital, Delaware

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $167
Cash Discount Price: $295
vs. Medicare Baseline: 1.56x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Nemours Children's Hospital, Delaware is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $295. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.56x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.

Cash / Self-Pay

$295

Average discount available for prompt cash payment at this facility.

Insurance Median

$167

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: $295 (276%)

Insurance Median: $167 (156%)

Cash: $295 (276% of Medicare)

Ins. Median: $167 (156% 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
Us Family Health Plan	$10	9%
Celtic Transplant	$47 - $295	44%
Keystone First Hlth Plan	$59 - $131	55%
Amerihealth Caritas Delaware	$90 - $168	84%
Blue Cross Blue Shield	$91 - $261	85%
Celtic Transplant For De First Health	$103	96%
Delaware First Health	$106	99%
UnitedHealthcare	$108 - $184	101%
Wellpoint Maryland	$109	102%
Tricare	$111	104%
Kidz Partners	$112	105%
Health Partners	$114	107%
Upmc	$117	110%
Fidelis	$118	110%
Aetna	$125 - $171	117%
Priority Partners John Hopkins	$145	136%
Six Degrees Health Transplant	$148	139%
Cigna	$162 - $186	152%
Great West-One Health Plan	$162 - $186	152%
Ambetter / Centene	$168	157%
Geisinger Health Plan	$177	166%
Integra Administrative Group	$177	166%
National Transplant Network (Ntn)	$192	180%
Six Degrees Health	$192	180%
Star Healthcare Network	$192	180%
Life Trac Solid Organ And Bmt Transplant	$206	193%
First Health Network	$280	262%
Insurance Administrators Of America	$280	262%
Interlink Transplant Network	$280	262%
Multiplan	$280	262%
Preferred Healthcare	$280	262%
Private Healthcare Systems	$280	262%
Three Rivers Provider Network	$280	262%

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 $295.
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 Nemours Children's Hospital, Delaware 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.