CMS Price Transparency Data

X-ray, pelvis

Facility: Ascension River District Hospital

Billing Code: 72170 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$84

about 0.8× the $107 Medicare rate · typically $23–$104

modeled estimate · not a bill or quote

Medicare pays $107 Fair price $84 Cash price $48 Hospital's list price $85

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ Aetna✓ Humana UnitedHealthcareBlue Cross Blue ShieldCignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
Aetnamajor	$104	97%
Humanamajor	$105	98%
Ambetter (Centene)	$130	122%
AmeriHealth	$103	96%
Meridian	$53	50%
Molina	$109 - $130	102%
WellCare	$109	102%
+ 9 smaller / regional plans	$16 - $198

Government programs also on file: Medicare, Military & VA.

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 48), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72170.

Insurance Before you use insurance

Call your insurance company to confirm Ascension River District Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 72170.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Ascension River District Hospital

Compare: X-ray, pelvis at other MI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.