CMS Price Transparency Data

X-ray, pelvis

Facility: Fairview Bethesda Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $203
Cash Discount Price: $145
vs. Medicare Baseline: 1.90x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Fairview Bethesda Hospital is $203. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $145. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.90x the Medicare baseline. Located in 45 10Th St W, Saint Paul, MN.

Cash / Self-Pay

$145

Average discount available for prompt cash payment at this facility.

Insurance Median

$203

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: $145 (136%)

Insurance Median: $203 (190%)

Cash: $145 (136% of Medicare)

Ins. Median: $203 (190% 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
Blue Cross Blue Shield	$6 - $213	6%
Health Partners	$6 - $282	6%
Hennepin Health	$6 - $108	6%
Itasca Medical Care	$6 - $106	6%
Medica	$6 - $262	6%
Primewest	$6 - $106	6%
South Country Health Alliance	$6 - $106	6%
Ucare	$6 - $243	6%
Sanford Health Plan	$8 - $213	7%
Security Health Plan	$8 - $272	7%
UnitedHealthcare	$8 - $207	7%
Wellcare	$8 - $106	7%
America'S Ppo	$188 - $261	176%
First Health	$296 - $297	277%
Multiplan	$306 - $308	286%
Private Healthcare Systems	$306 - $308	286%
Wisconsin Physician Services	$324 - $326	303%

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 $145.
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 Fairview Bethesda 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.