CMS Price Transparency Data

X-ray, pelvis

Facility: Memorial Hospital and Manor

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $341
  • Cash Discount Price: $309
  • vs. Medicare Baseline: 3.19x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Memorial Hospital and Manor is $341. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $309. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.19x the Medicare baseline. Located in 1500 E Shotwell Street, Bainbridge, GA.
Cash / Self-Pay
$309

Average discount available for prompt cash payment at this facility.

Insurance Median
$341

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: $309 (289%)
Insurance Median: $341 (319%)
Cash: $309 (289% of Medicare)
Ins. Median: $341 (319% 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 319% of the Medicare baseline (a markup of 219%). 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
Tricare $85 80%
Aetna $92 - $398 86%
Humana $92 - $354 86%
Medicare (plans) $92 86%
Wellcare_Plan $92 86%
Ambetter / Centene $120 112%
Alliant_Plan $147 138%
Amerigroup_Plan $278 260%
Medicaid / KanCare $278 260%
Peach_State_Health_Plan_Plan $278 260%
Caresource_Plan $292 273%
Blue Cross Blue Shield $341 319%
Uhc_Plan $349 327%
Novanet_Plan $354 331%
Cigna $367 344%
Private_Healthcare_Systems_Plan $376 352%
Multiplan_Plan $398 373%
Corvel_Plan $420 393%
Tnga_Plan $450 421%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 E Shotwell Street, Bainbridge, GA 39819
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals