CMS Price Transparency Data

X-ray, pelvis

Facility: Woodlawn Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $102
Cash Discount Price: $339
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Woodlawn Hospital is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $339. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.95x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$339

Average discount available for prompt cash payment at this facility.

Insurance Median

$102

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: $339 (317%)

Insurance Median: $102 (95%)

Cash: $339 (317% of Medicare)

Ins. Median: $102 (95% 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
Blue Cross Blue Shield	$14 - $362	13%
Caresource Mcaid Hww	$14	13%
Mdwise Excel Hhw & Hcc	$14	13%
Mhs Mcaid Hcc	$14	13%
Mhs Mcaid Hhw	$14	13%
UnitedHealthcare	$14 - $344	13%
Aetna	$99 - $429	93%
Caresource Mcaid Hip	$99	93%
Caresource Mcr Adv	$99	93%
Humana	$99 - $351	93%
Mdwise Mcaid Excel Hip	$99	93%
Mhs Exch Mrktplce-All Other Plans	$99	93%
Mhs Mcaid Hip	$99	93%
Mhs Mcr Adv	$101	95%
Caresource Exch - All Other Plans	$129	121%
Ambetter / Centene	$132	124%
Partners Direct Health-All Plans	$307	287%
Cigna	$324 - $384	303%
Parkview Health Plans-All Plans	$339	317%
Sagamore All Other Grps - All Other Plans	$380	356%
Encore Comm-All Plans	$384	360%
Phcs/Multiplan-All Plans	$420	393%
Community Health Alliance-All Plans	$429	402%

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 $339.
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 Woodlawn Hospital 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.