CMS Price Transparency Data

X-ray, pelvis

Facility: Terrebonne General Medical Center - Parish

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $204
Cash Discount Price: $234
vs. Medicare Baseline: 1.91x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Terrebonne General Medical Center - Parish is $204. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $234. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.91x the Medicare baseline. Located in 8166 Main Street, Houma, LA.

Cash / Self-Pay

$234

Average discount available for prompt cash payment at this facility.

Insurance Median

$204

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: $234 (219%)

Insurance Median: $204 (191%)

Cash: $234 (219% of Medicare)

Ins. Median: $204 (191% 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
Champ Va	$17	16%
Ppoplus	$55	51%
Medicaid / KanCare	$57	53%
UnitedHealthcare	$57 - $316	53%
Aetna	$58 - $84	54%
Amerihealth	$58	54%
Humana	$59 - $285	55%
Blue Cross Blue Shield	$93 - $279	87%
Dept Of Veterans Affairs	$93	87%
Medicare (plans)	$93	87%
Tricare	$95	89%
Amg	$99	93%
Verity Health	$180	169%
Multiplan Inc	$205	192%
Cigna	$212	198%
Vantage Health Plan	$237	222%
Coventry Health Of Louisiana	$253	237%
Gilsbar 360	$311 - $325	291%
Workers Comp	$316	296%

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 $234.
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 Terrebonne General Medical Center - Parish 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.