CMS Price Transparency Data

X-ray, pelvis

Facility: Essentia Health

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $143
Cash Discount Price: $200
vs. Medicare Baseline: 1.34x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Essentia Health is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $200. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.34x the Medicare baseline. Located in 3000 32Nd Ave South, Fargo, ND.

Cash / Self-Pay

$200

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $200 (187%)

Insurance Median: $143 (134%)

Cash: $200 (187% of Medicare)

Ins. Median: $143 (134% 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
Medica Access	$72	67%
Healthpartners Care Pmap	$104	97%
Advocare/Security Health	$106	99%
Blue Cross Blue Shield	$106 - $251	99%
Freedom Blue Ppo	$106	99%
Healthpartners Care Msho / Mcr Adv	$106	99%
Imcare Msho Pcc Prime	$106	99%
Imcare Msho Ref Req	$106	99%
Itasca Med Care	$106	99%
Medica Advantage Solutions	$106	99%
Medica Msho/Dual Solutions	$106	99%
Medica Prime Solution Group	$106	99%
Medicare (plans)	$106	99%
Nd Va Administration	$106	99%
Platinum Blue/Vantage Blue	$106	99%
Primewest	$106	99%
Primewest Msho	$106	99%
Secure Blue Msho	$106	99%
Ubh Cost Plan	$106	99%
Ubh Msho	$106	99%
Ucare Msho	$106	99%
UnitedHealthcare	$106 - $213	99%
Sanford Health Plan	$115 - $188	108%
Medica	$148 - $164	139%
Medica Uplan	$148	139%
Medica Choice	$169	158%
Ucare	$176	165%
Cigna	$179	168%
Healthpartners	$179	168%
Healthpartners Pcc Prime	$179	168%
Wea	$192 - $206	180%
America'S Ppo	$207	194%
Wps	$222 - $224	208%
Aetna	$227	213%

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 $200.
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 Essentia Health 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.