CMS Price Transparency Data

X-ray, pelvis

Facility: Mary Free Bed Rehabilitation Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $41
Cash Discount Price: $80
vs. Medicare Baseline: 0.38x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Mary Free Bed Rehabilitation Hospital is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.38x the Medicare baseline. Located in 235 Wealthy St Se, Grand Rapids, MI.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$41

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: $80 (75%)

Insurance Median: $41 (38%)

Cash: $80 (75% of Medicare)

Ins. Median: $41 (38% 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
Aetna	$18 - $200	17%
Blue_Cross_Blue_Shield_Of_Michigan	$18 - $232	17%
Healthplus_Partners	$18	17%
Mclaren_Health_Plan_Inc	$18 - $167	17%
Meridian_Health_Plan	$18 - $26	17%
Midwest_Health_Plan	$18	17%
Molina_Healthcare	$18 - $26	17%
Priority_Health	$18 - $26	17%
United_Healthcare	$18 - $31	17%
Health_Alliance_Plan_(Hap)	$26	24%
Humana	$26 - $35	24%
University_Of_Michigan_Health_Plan	$26 - $206	24%
Asr	$35 - $73	33%
Cigna	$39 - $253	37%
Multiplan	$44 - $244	41%
Three_Rivers_Provider_Network_Trpn	$45 - $243	42%

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 $80.
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 Mary Free Bed Rehabilitation 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.