CMS Price Transparency Data

X-ray, pelvis

Facility: St Mary's Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $151
Cash Discount Price: $111
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at St Mary's Hospital is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.41x the Medicare baseline. Located in 701 Lewiston St, Cottonwood, ID.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

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: $111 (104%)

Insurance Median: $151 (141%)

Cash: $111 (104% of Medicare)

Ins. Median: $151 (141% 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
Nimiipuu Mcr Adv - Allplans	$8 - $223	7%
Regence Blue Shield Mcr	$8 - $221	7%
Tricare	$8 - $221	7%
UnitedHealthcare	$8 - $221	7%
Veterans Admin - All Plans	$8 - $221	7%
Blue Cross Blue Shield	$9 - $258	8%
Medicare (plans)	$9 - $221	8%
Aetna	$13 - $250	12%
First Choice- All Plans	$25 - $264	23%
Geha - All Plans	$25 - $261	23%
Idaho Phys Network - All Plans	$25 - $256	23%
Multiplan - All Plans	$25 - $261	23%
Corizon Correctional - All Plans	$28 - $258	26%
Regence Blue Shield - All Other Plans	$269	252%

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 $111.
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 St Mary's Hospital 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.