CMS Price Transparency Data

X-ray, pelvis

Facility: HSHS St Elizabeth's Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $449
  • Cash Discount Price: $407
  • vs. Medicare Baseline: 4.20x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at HSHS St Elizabeth's Hospital is $449. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $407. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.20x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$407

Average discount available for prompt cash payment at this facility.

Insurance Median
$449

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: $407 (381%)
Insurance Median: $449 (420%)
Cash: $407 (381% of Medicare)
Ins. Median: $449 (420% 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 420% of the Medicare baseline (a markup of 320%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Molina Healthcare $51 - $124 48%
Meridian Health Plan $54 51%
Aetna $119 - $398 111%
Blue Cross Blue Shield $119 - $565 111%
Clear Spring Health Of Illinois $119 111%
Health Alliance Medical Plans $119 - $480 111%
Health Partners $119 111%
Humana $119 111%
Sae Hospice $119 111%
UnitedHealthcare $119 - $565 111%
Amish Community $158 148%
Celtic Insurance Company $237 222%
Naphcare $257 241%
Hopetrust $285 267%
Claim Doc $297 278%
Wellfirst $364 341%
First Health $420 393%
Cigna $446 - $565 418%
Healthlink $449 - $565 420%
Caterpillar, Inc. $454 425%
Consociate Group $497 465%
Choicecare $508 476%
Healthcare Finest Network (Hfn) $508 476%
Multiplan/Phcs $508 476%
Provider Network Of America $508 476%
City Of Springfield $565 529%
Current Health Solutions $565 529%
Healthscope $565 529%
Illinois Breast And Cervical Cancer Program $565 529%
Interplan $565 529%
Live360 $565 529%
Wexford $565 529%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals