CMS Price Transparency Data

X-ray, pelvis

Facility: Sanford Jackson Medical Center

Billing Code: 72170 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$111

about 1.0× the $107 Medicare rate · typically $36–$202

modeled estimate · not a bill or quote

What this hospital charges insurers

$112

About the fair price

about $1 over the fair price · 1.0× Medicare

Medicare pays $107 Fair price $111 This hospital $112 Cash price $391 Hospital's list price $489

How we calculate the fair BaseRate →

How this hospital compares to other MN hospitals

Highest price of the 9 MN hospitals we have prices for — worth calling around.

Cheapest $21 Priciest $112

Black dot = this hospital, among the 9 MN hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a X-ray, pelvis is about $111 (about 1.0× the $107 Medicare rate). Sanford Jackson Medical Center charges insurers about $112, or about $391 in cash — about the fair price. Located in Jackson, MN.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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
UnitedHealthcaremajor	$166 - $408	155%
Blue Cross Blue Shieldmajor	$118 - $452	110%
Aetnamajor	$166 - $425	155%
Cignamajor	$440	412%
Health Net	$440	412%
HealthPartners	$166 - $391	155%
Medica	$430 - $463	403%
Sanford Health Plan	$154 - $308	144%
Security Health Plan	$269	252%
UCare	$112 - $430	105%
+ 2 smaller / regional plans	$169 - $440

Government programs also on file: Medicare.

Excludes 1 rental-network / third-party entry (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 391), 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 Sanford Jackson Medical Center 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 Sanford Jackson Medical Center

Compare: X-ray, pelvis at other MN hospitals

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