CMS Price Transparency Data

X-ray, pelvis

Facility: Memorial Hospital at Gulfport

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $181
Cash Discount Price: $520
vs. Medicare Baseline: 1.69x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Memorial Hospital at Gulfport is $181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $520. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.69x the Medicare baseline. Located in 4500 13Th Street, Gulfport, MS.

Cash / Self-Pay

$520

Average discount available for prompt cash payment at this facility.

Insurance Median

$181

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: $520 (487%)

Insurance Median: $181 (169%)

Cash: $520 (487% of Medicare)

Ins. Median: $181 (169% 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
Cigna	$37 - $446	35%
UnitedHealthcare	$81 - $179	76%
Magnolia Health	$83 - $141	78%
Molina	$84 - $150	79%
Blue Cross Blue Shield	$100 - $595	94%
Humana	$102 - $535	95%
Sas Mhg	$112 - $454	105%
Aetna	$172	161%
Fox Everett	$183	171%
First Choice	$206 - $535	193%
Sas Non-Mhg	$206	193%
Mhg	$217	203%
Primewell	$225	211%
First Health	$535	501%
Mpcn	$558	522%

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 $520.
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 Memorial Hospital at Gulfport 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.