CMS Price Transparency Data

X-ray, pelvis

Facility: Helen Newberry Joy Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $160
Cash Discount Price: $106
vs. Medicare Baseline: 1.50x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Helen Newberry Joy Hospital is $160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.50x the Medicare baseline. Located in 502 W Harrie St, Newberry, MI.

Cash / Self-Pay

$106

Average discount available for prompt cash payment at this facility.

Insurance Median

$160

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: $106 (99%)

Insurance Median: $160 (150%)

Cash: $106 (99% of Medicare)

Ins. Median: $160 (150% 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
Mi Wc - All Plans	$11 - $126	10%
Aetna	$16 - $321	15%
Uphg Tpa - All Plans	$16 - $177	15%
Cigna	$17 - $191	16%
First Health - All Plans	$17 - $187	16%
Health Alliance - All Plans	$17 - $191	16%
Healtheos - All Plans	$17 - $191	16%
Ppom/Cofinity - All Plans	$17 - $187	16%
Priority Health - All Plans	$17 - $191	16%
UnitedHealthcare	$17 - $191	16%
Vital Core - All Plans	$17 - $191	16%
Blue Cross Blue Shield	$18 - $321	17%
Humana	$67 - $321	63%
Mi Health Link - All Plans	$67 - $321	63%
Va - All Plans	$69 - $253	65%
Uphp Mcaid - All Plans	$79 - $229	74%

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 $106.
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 Helen Newberry Joy 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.