CMS Price Transparency Data

X-ray, pelvis

Facility: Atrium Health Navicent Rehabilitation Hopsital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $42
Cash Discount Price: $191
vs. Medicare Baseline: 0.39x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Atrium Health Navicent Rehabilitation Hopsital is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $191. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.39x the Medicare baseline. Located in 3351 Northside Dr, Macon, GA.

Cash / Self-Pay

$191

Average discount available for prompt cash payment at this facility.

Insurance Median

$42

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: $191 (179%)

Insurance Median: $42 (39%)

Cash: $191 (179% of Medicare)

Ins. Median: $42 (39% 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	$8 - $264	7%
Blue Cross Blue Shield	$8 - $106	7%
Care Source	$8 - $108	7%
Clover	$8 - $108	7%
Eon Health	$8 - $108	7%
Georgia Health Advantage	$8 - $106	7%
Humana	$8 - $262	7%
Pruitt Health	$8 - $106	7%
UnitedHealthcare	$8 - $712	7%
Alliant	$9 - $128	8%
Ambetter / Centene	$11 - $195	10%
Cigna	$20 - $93	19%
Securehealth	$20 - $134	19%
Ibg	$24 - $270	22%
Kaiser	$27 - $248	25%
Multiplan	$248 - $306	232%
Novanet	$306	286%
Three Rivers Provider Network	$325	304%
Beechstreet	$355	332%

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 $191.
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 Atrium Health Navicent Rehabilitation Hopsital 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.