CMS Price Transparency Data

X-ray, pelvis

Facility: Northside Hospital Cherokee

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $306
  • Cash Discount Price: $459
  • vs. Medicare Baseline: 2.86x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Northside Hospital Cherokee is $306. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $459. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.86x the Medicare baseline. Located in 450 Northside Cherokee Boulevard, Canton, GA.
Cash / Self-Pay
$459

Average discount available for prompt cash payment at this facility.

Insurance Median
$306

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: $459 (430%)
Insurance Median: $306 (286%)
Cash: $459 (430% of Medicare)
Ins. Median: $306 (286% 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 286% of the Medicare baseline (a markup of 186%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Champus Va $19 18%
Oscar $33 31%
Lantern $37 35%
Ambetter / Centene $39 - $117 37%
Blue Cross Blue Shield $46 - $427 43%
Streamline Imaging $46 43%
Mti $47 44%
One Call Diagnostics $47 44%
Homelink $50 47%
Amerigroup $68 - $91 64%
Medicaid / KanCare $68 - $79 64%
Caresource $70 - $228 66%
Cherokee County Board Of Health $89 83%
Cigna $92 - $386 86%
Clear Springs Eon Health $104 97%
Medicare (plans) $104 - $127 97%
UnitedHealthcare $104 - $433 97%
Va Ccn $104 97%
Bccp $106 99%
Cbww $106 99%
Humana $106 - $109 99%
Tricare $106 99%
Aetna $107 - $416 100%
Coventry $107 - $416 100%
Kaiser $108 - $532 101%
Wellcare $108 101%
Clover Health $110 103%
Pruitt Health Premier $110 103%
Truths Community $112 105%
Fairly Group $120 112%
Good Samaritan Radiology $122 114%
Us Dept Of Labor Wc $133 125%
Med Care Solutions $160 150%
Medlien Healthcare Services $160 150%
Northside Health Network $171 160%
Genex/Priority Care Solutions $223 209%
Spreemo $223 209%
Georgia Reproductive Specialists $245 229%
Authentic 4D $251 235%
Direct Pay Provider Network Llc $251 235%
Corvel Workers Comp $265 248%
Employers Choice Network $265 248%
Fieldale Farms Wc $279 261%
Georgia Workers Compensation $279 261%
Health One Alliance_Ppo $337 316%
Quick Trip $337 316%
Novanet_Ppo $428 401%
Phcs $459 430%
Beech Steet $520 487%
Multiplan $520 487%
Multiplan Workers Comp $520 487%
Careiq $612 573%
Dekalb_Department Of Health $612 573%
Fifa $612 573%
Institutional Marietta Surgery Center $612 573%
Institutional Veterans Evaluation Services $612 573%
Rabun County Boc $612 573%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 450 Northside Cherokee Boulevard, Canton, GA 30115
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals