CMS Price Transparency Data

X-ray, pelvis

Facility: Methodist Hospitals Inc

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $406
Cash Discount Price: $562
vs. Medicare Baseline: 3.80x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Methodist Hospitals Inc is $406. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $562. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.80x the Medicare baseline. Located in 600 Grant St, Gary, IN.

Cash / Self-Pay

$562

Average discount available for prompt cash payment at this facility.

Insurance Median

$406

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: $562 (526%)

Insurance Median: $406 (380%)

Cash: $562 (526% of Medicare)

Ins. Median: $406 (380% 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 380% of the Medicare baseline (a markup of 280%). 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	$54 - $771	51%
Caresource	$54	51%
Humana	$54 - $110	51%
Managed Health Services	$54	51%
Medicaid / KanCare	$54	51%
UnitedHealthcare	$54 - $402	51%
Aetna	$110 - $664	103%
Medicare (plans)	$110	103%
United Heathcare	$110	103%
Zing	$112	105%
Caresource Maketplace	$182	170%
Ambetter / Centene	$220	206%
Cigna	$272 - $374	255%
Physicians Health Plan Of Northern Indiana	$409 - $518	383%
Encore	$425 - $798	398%
Phcs	$481 - $610	450%
Siho	$496 - $628	464%
Sagamore	$510 - $646	477%
Multiplan	$517 - $655	484%
Magnacare	$523	490%
Hfn	$552 - $762	517%

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 $562.
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 Methodist Hospitals Inc 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.