CMS Price Transparency Data

X-ray, pelvis

Facility: Children's Healthcare of Atlanta at Scottish Rite

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $276
Cash Discount Price: $403
vs. Medicare Baseline: 2.58x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Children's Healthcare of Atlanta at Scottish Rite is $276. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $403. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.58x the Medicare baseline. Located in 1001 Johnson Ferry Road, Atlanta, GA.

Cash / Self-Pay

$403

Average discount available for prompt cash payment at this facility.

Insurance Median

$276

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: $403 (377%)

Insurance Median: $276 (258%)

Cash: $403 (377% of Medicare)

Ins. Median: $276 (258% 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 258% of the Medicare baseline (a markup of 158%). 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
Peachstate [43]	$168	157%
Caresource [61]	$173	162%
Amerigroup [102]	$175	164%
Cigna	$266	249%
Blue Cross Blue Shield	$267 - $393	250%
United [5]	$267	250%
Ambetter / Centene	$270	253%
Oscar [228]	$270	253%
Aetna	$271	254%
Caresource Marketplace Bronze/Silver/Gold [60]	$274	257%
Kaiser [6]	$274	257%
Sidecar Health [236]	$278	260%
Direct Employer Agreements [72]	$282 - $343	264%
Coventry [9]	$283	265%
First Health [74]	$302	283%
Northeast Georgia Heatlh System [808]	$302	283%
Veracity Benefits [809]	$302	283%
Phcs [93]	$343	321%
Secure Health [340]	$343	321%
Beech Street [71]	$363	340%
Multiplan [92]	$395	370%
Novanet [41]	$403	377%

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 $403.
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 Children's Healthcare of Atlanta at Scottish Rite 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.