CMS Price Transparency Data

X-ray, pelvis

Facility: Nemours Childrens Hospital, Florida

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $199
Cash Discount Price: $485
vs. Medicare Baseline: 1.86x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Nemours Childrens Hospital, Florida is $199. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $485. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.86x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.

Cash / Self-Pay

$485

Average discount available for prompt cash payment at this facility.

Insurance Median

$199

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: $485 (454%)

Insurance Median: $199 (186%)

Cash: $485 (454% of Medicare)

Ins. Median: $199 (186% 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
Truli	$64 - $194	60%
Florida Blue	$72 - $296	67%
Aetna	$82 - $213	77%
Tricare	$107	100%
Avmed	$150	140%
Employers Health Network Fl	$194	182%
Cigna	$196 - $198	184%
Evolutions Healthcare	$218	204%
UnitedHealthcare	$257	241%
Integra Administrative Group	$291	272%
Global Medical Management	$315	295%
Prime Health Services	$315	295%
Star Healthcare Network	$315	295%
Velocity	$364	341%
First Health Network	$378	354%
Pnoa	$388	363%
Seminole Tribe Of Fl	$388	363%
Private Healthcare Systems	$446	418%

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 $485.
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 Childrens Hospital, Florida 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.