CMS Price Transparency Data

X-ray, pelvis

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $30
  • Cash Discount Price: $211
  • vs. Medicare Baseline: 0.28x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Munson Healthcare Otsego Memorial Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $211. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.28x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.
Cash / Self-Pay
$211

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $211 (198%)
Insurance Median: $30 (28%)
Cash: $211 (198% of Medicare)
Ins. Median: $30 (28% 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.

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 $5 - $155 5%
Mclaren Health Plan $5 - $208 5%
Meridian $5 - $54 5%
Molina $5 - $112 5%
Priority Health $5 - $104 5%
UnitedHealthcare $5 - $199 5%
Aetna $8 - $201 7%
Blue Care Network $8 - $104 7%
Hap (Health Alliance Plan) $8 - $198 7%
Humana $8 - $104 7%
Medicare (plans) $8 - $104 7%
Michigan Amish Medical Board $8 - $104 7%
Northern Michigan Mennonite Group $8 - $104 7%
Asr Physicians Care Network $12 - $198 11%
Cigna $13 - $65 12%
Nomi Health $13 - $198 12%
Employee Benefit Logistics $14 - $177 13%
Munson Hospice $124 - $852 116%
Hospice Of Michigan $149 140%
Enterprise Group Planning/Employee Benefit Plan $198 185%
Cofinity $211 198%
Provider Network Of America/Hawaii Mainland Administrative Group Health $211 198%
Three Rivers Provider Network $211 198%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 825 N Center Ave, Gaylord, MI 49735
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals