CMS Price Transparency Data

X-ray, pelvis

Facility: Mt Sinai Hospital Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $112
  • Cash Discount Price: $194
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Mt Sinai Hospital Medical Center is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $194. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.05x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$194

Average discount available for prompt cash payment at this facility.

Insurance Median
$112

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: $194 (182%)
Insurance Median: $112 (105%)
Cash: $194 (182% of Medicare)
Ins. Median: $112 (105% 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.

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
Partners In Hlth - All Plans $10 - $212 9%
Blue Cross Blue Shield $11 - $337 10%
Healthlink Hmo $13 - $265 12%
Healthlink Ppo - All Other Plans $13 - $265 12%
Compsych Ip/Op Only - All Plans $15 - $318 14%
Hfn Platinum $17 - $344 16%
Multiplan Primary Ntwrk/Phcs - All Other Plans $18 - $371 17%
Hfn Epo $20 - $424 19%
Multiplan Complementary Ntwrk $20 - $424 19%
Hfn Ppo - All Other Plans $23 - $466 22%
Ambetter / Centene $27 - $556 25%
Oscar - All Plans $27 - $556 25%
Cigna $32 - $843 30%
Aetna $58 - $1,196 54%
Humana $80 - $1,662 75%
Family Health Network Mcaid - All Plans $84 79%
Molina Mcaid $88 82%
Tricare $109 102%
Va Healthnet - All Plans $109 102%
Advocate Physician Prtnrs Mcr $112 105%
Cenpatico Illinicare Dual $112 105%
Cenpatico Illinicare Mcr - All Other Plans $112 105%
Lawndale Christian - All Plans $112 105%
Meridian/Harmony D-Snp - All Plans $112 105%
Nextlevel Hlth Icp Fhp Aca - All Plans $112 105%
UnitedHealthcare $112 - $283 105%
Harmony Behavioral Htlh - All Plans $115 108%
Zing Mcr Adv - All Plans $117 110%
Molina Mcr - All Other Plans $118 110%
Advocate Physician Prtnrs - All Other Plans $123 115%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals