CMS Price Transparency Data

X-ray, pelvis

Facility: UW Health

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $43
Cash Discount Price: $23
vs. Medicare Baseline: 0.40x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at UW Health is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.40x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.

Cash / Self-Pay

$23

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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: $23 (22%)

Insurance Median: $43 (40%)

Cash: $23 (22% of Medicare)

Ins. Median: $43 (40% 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
Aetna	$18 - $367	17%
Blue Cross Blue Shield	$18 - $252	17%
Humana	$18 - $107	17%
Medicaid / KanCare	$18 - $36	17%
Medicare (plans)	$18 - $117	17%
Mychoice Wi Medical Adv	$18 - $107	17%
UnitedHealthcare	$18 - $391	17%
Quartz Aso	$28 - $278	26%
Quartz Fully Insured	$28 - $176	26%
Cigna	$30 - $406	28%
Ecoh	$37 - $400	35%
Hfn	$37 - $400	35%
Alliance Premier Network	$39 - $277	37%
The Alliance	$42 - $357	39%
Wps	$54 - $71	51%
Beloit Healt System	$63 - $459	59%
Mercy Care	$76 - $100	71%
Workers Comp	$108 - $117	101%
Wps Ppo	$393	368%
Mercycare	$475	445%
First Health/Coventry	$500	468%
Health Payment Systems	$593	555%
Healthsmart	$593	555%
Sheboygan Employers Health Network	$633	593%
Multiplan	$707	662%

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 $23.
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 UW Health 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.