CMS Price Transparency Data

X-ray, pelvis

Facility: St Joseph's Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $415
  • Cash Discount Price: $404
  • vs. Medicare Baseline: 3.89x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at St Joseph's Hospital is $415. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $404. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.89x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$404

Average discount available for prompt cash payment at this facility.

Insurance Median
$415

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: $404 (378%)
Insurance Median: $415 (389%)
Cash: $404 (378% of Medicare)
Ins. Median: $415 (389% 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 389% of the Medicare baseline (a markup of 289%). 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
Cigna $53 50%
Blue Cross Blue Shield $112 105%
Molina Healthcare $112 - $113 105%
Aetna $112 - $392 105%
Clear Spring Health of Illinois $112 105%
UnitedHealthcare $112 - $561 105%
Sae Hospice $112 105%
Humana $112 105%
Meridian Health Plan $119 111%
Amish Community $157 147%
Naphcare $236 221%
Celtic Insurance Company $247 231%
Claim Doc $280 262%
Hopetrust $280 262%
Wellfirst $359 336%
First Health $415 389%
Multiplan/Phcs $477 447%
Healthlink $477 447%
Healthcare Finest Network (Hfn) $505 473%
Provider Network of America $505 473%
Mental Health Network $561 525%
Health Alliance Medical Plans $561 525%
Caterpillar, Inc. $561 525%
Qtc Medical Group of Illinois $561 525%
Healthscope $561 525%
Interplan $561 525%
Illinois Breast and Cervical Cancer Program $561 525%
Consociate Group $561 525%
Current Health Solutions $561 525%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals