CMS Price Transparency Data

X-ray, pelvis

Facility: Memorial Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $326
Cash Discount Price: $543
vs. Medicare Baseline: 3.05x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Memorial Medical Center is $326. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $543. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.05x the Medicare baseline. Located in 701 N First St, Springfield, IL.

Cash / Self-Pay

$543

Average discount available for prompt cash payment at this facility.

Insurance Median

$326

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: $543 (508%)

Insurance Median: $326 (305%)

Cash: $543 (508% of Medicare)

Ins. Median: $326 (305% 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 305% of the Medicare baseline (a markup of 205%). 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
Blue Cross Blue Shield	$26 - $543	24%
Healthlink	$44 - $342	41%
Medicaid / KanCare	$70	66%
Molina	$72	67%
Veterans Administration	$79	74%
Aetna	$110 - $413	103%
Health Alliance	$110 - $394	103%
Medicare (plans)	$110 - $543	103%
Tricare	$110	103%
UnitedHealthcare	$110 - $337	103%
Humana	$116 - $326	109%
Commercial Workers Compensation	$191	179%
Illinois Workers Compensation	$201	188%
Current Health Network Ppo	$244	228%
Cigna	$285	267%
Phcs/Multiplan	$293 - $326	274%
6 Degrees Health	$326	305%
Hopetrust	$326	305%
Hst	$326	305%
Magellan	$326	305%
Consociate	$353	330%
Hfn	$353	330%
Preferred Plan	$407	381%
Soi Mcfarland	$407	381%
Soi Rushville	$407	381%
Corvel	$434	406%
Methodist First Choice	$434	406%
Mutual Medical Plans	$462	433%
Liability	$543	508%

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 $543.
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 Memorial Medical Center 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.