CMS Price Transparency Data

X-ray, pelvis

Facility: HCA Florida Orange Park Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $992
Cash Discount Price: $2,421
vs. Medicare Baseline: 9.29x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at HCA Florida Orange Park Hospital is $992. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,421. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.29x the Medicare baseline. Located in 2001 Kingsley Ave, Orange Park, FL.

Cash / Self-Pay

$2,421

Average discount available for prompt cash payment at this facility.

Insurance Median

$992

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: $2,421 (2267%)

Insurance Median: $992 (929%)

Cash: $2,421 (2267% of Medicare)

Ins. Median: $992 (929% 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 929% of the Medicare baseline (a markup of 829%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Optimum Healthcare	$203 - $204	190%
United	$245 - $1,090	229%
Avmed	$290 - $678	272%
Simply Healthcare	$373	349%
Corvel Corporation	$385	360%
Prime Health	$393	368%
Positive Healthcare	$532 - $533	498%
Sunshine State Health Plan	$617 - $618	578%
Molina Healthcare	$653 - $654	611%
Aetna	$726 - $727	680%
Humana	$992 - $993	929%
Medicare (plans)	$1,089 - $1,090	1020%
Plotkin Health	$1,210 - $1,211	1133%
Multiplan	$1,888 - $2,059	1768%
Evernorth	$1,936 - $1,938	1813%
Evolutions Healthcare	$1,936 - $2,059	1813%
Ppo Next	$2,057 - $2,059	1926%
Novanet	$2,178 - $2,180	2039%

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 $2,421.
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 HCA Florida Orange Park 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.