CMS Price Transparency Data

X-ray, pelvis

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $48
Cash Discount Price: $300
vs. Medicare Baseline: 0.45x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Cleveland Clinic Indian River Hospital is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $300. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.45x the Medicare baseline. Located in 1000 36Th St, Vero Beach, FL.

Cash / Self-Pay

$300

Average discount available for prompt cash payment at this facility.

Insurance Median

$48

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: $300 (281%)

Insurance Median: $48 (45%)

Cash: $300 (281% of Medicare)

Ins. Median: $48 (45% 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	$7 - $679	7%
Avmed	$8 - $244	7%
Blue Cross Blue Shield	$8 - $572	7%
Careplus	$8 - $107	7%
Magellan	$8 - $509	7%
United	$8 - $107	7%
Value Options	$8	7%
Wellcare	$8 - $107	7%
Clear Spring Health	$9 - $40	8%
Freedom Health	$9 - $107	8%
Independent Living Systems	$9 - $112	8%
Wellmed	$9 - $107	8%
Cigna	$10 - $255	9%
Clarity Health	$48 - $552	45%
The Legacy Companies	$48 - $552	45%
National Provider Network	$52	49%
Three Rivers	$52	49%
Consociate Health	$56	52%
Carelon Bh Strategies	$107	100%
Humana	$107	100%
Devoted Health	$117	110%
Bmi	$467	437%
Multiplan	$679	636%

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 $300.
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 Cleveland Clinic Indian River 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.