CMS Price Transparency Data

X-ray, pelvis

Facility: North Carolina Baptist Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $267
Cash Discount Price: $406
vs. Medicare Baseline: 2.50x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at North Carolina Baptist Hospital is $267. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $406. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.50x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.

Cash / Self-Pay

$406

Average discount available for prompt cash payment at this facility.

Insurance Median

$267

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: $406 (380%)

Insurance Median: $267 (250%)

Cash: $406 (380% of Medicare)

Ins. Median: $267 (250% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 250% of the Medicare baseline (a markup of 150%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$103 - $709	96%
Apex	$103	96%
Blue Cross Blue Shield	$103 - $282	96%
Cigna	$103 - $500	96%
Devoted	$103	96%
Healthteam	$103	96%
UnitedHealthcare	$103 - $288	96%
Wellcare	$103 - $191	96%
Humana	$104 - $456	97%
Medicare (plans)	$104	97%
Liberty	$118	110%
Medcost	$156 - $555	146%
Amerihealth	$179 - $225	168%
Carolina Complete	$179 - $188	168%
Health Blue	$179 - $188	168%
Partners	$179 - $188	168%
Vaya	$180 - $190	169%
Alliance	$182 - $192	170%
Trillium	$184 - $194	172%
Ambetter / Centene	$213 - $225	199%
Oscar	$237 - $300	222%
Directnet	$467 - $493	437%
Cone Health	$553 - $584	518%
Healthgram	$553 - $584	518%
First Carolina Care	$632 - $667	592%
Private Healthcare Systems	$648 - $684	607%
Multiplan	$711 - $751	666%

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 $406.
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 North Carolina Baptist 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.