CMS Price Transparency Data

X-ray, pelvis

Facility: Adventist Health Castle

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $149
Cash Discount Price: $85
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Adventist Health Castle is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.40x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.

Cash / Self-Pay

$85

Average discount available for prompt cash payment at this facility.

Insurance Median

$149

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: $85 (80%)

Insurance Median: $149 (140%)

Cash: $85 (80% of Medicare)

Ins. Median: $149 (140% 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
Multiplan Hmn - All Plans	$12	11%
UnitedHealthcare	$19	18%
Hmsa Hmo	$34	32%
Hmsa Ppo - All Other Plans	$34	32%
Alohacare Quest Mcaid - All Other Plans	$45 - $87	42%
Pacific Admin Ppo - All Plans	$115 - $221	108%
Kfh Mcr Adv	$124	116%
Medicare (plans)	$124	116%
Ohana Health Plan - All Plans	$126	118%
Devoted Hlth Mcr Adv - All Plans	$130	122%
Hwmg/Hmaa - All Plans	$133 - $256	125%
Mdx Hawaii Ppo - All Plans	$144 - $278	135%
Health Alliance - All Plans	$145 - $278	136%
Kfh - All Other Plans	$154 - $296	144%
Uni Health Alliance - All Plans	$169 - $325	158%
First Health Ppo - All Plans	$170 - $327	159%
Medicaid / KanCare	$181 - $348	169%
State Of Hi Nonprofit - All Plans	$317 - $609	297%

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 $85.
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 Adventist Health Castle 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.