CMS Price Transparency Data

X-ray, pelvis

Facility: Mount Desert Island Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $27
Cash Discount Price: $39
vs. Medicare Baseline: 0.25x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Mount Desert Island Hospital is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.25x the Medicare baseline. Located in 10 Wayman Lane, Bar Harbor, ME.

Cash / Self-Pay

$39

Average discount available for prompt cash payment at this facility.

Insurance Median

$27

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: $39 (37%)

Insurance Median: $27 (25%)

Cash: $39 (37% of Medicare)

Ins. Median: $27 (25% 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
Martins Point	$19	18%
Wellcare	$19	18%
Aetna	$19 - $39	18%
UnitedHealthcare	$19 - $26	18%
Blue Cross Blue Shield	$19 - $33	18%
Cigna	$19 - $40	18%
Healthnet	$28	26%
Community Health Options	$37	35%
Harvard Pilgrim	$39	37%
First Health	$41	38%

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 $39.
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 Mount Desert Island 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.