CMS Price Transparency Data

X-ray, pelvis

Facility: Cape Regional Medical Center Inc

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $221
  • Cash Discount Price: $135
  • vs. Medicare Baseline: 2.07x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Cape Regional Medical Center Inc is $221. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $135. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.07x the Medicare baseline. Located in Two Stone Harbor Blvd, Cape May Court House, NJ.
Cash / Self-Pay
$135

Average discount available for prompt cash payment at this facility.

Insurance Median
$221

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: $135 (126%)
Insurance Median: $221 (207%)
Cash: $135 (126% of Medicare)
Ins. Median: $221 (207% 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 207% of the Medicare baseline (a markup of 107%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Amerihealth $35 33%
Aetna $72 - $130 67%
Americhoice $72 - $121 67%
Amerigroup $75 70%
Horizon Nj Health $75 70%
Clover Health $121 113%
Partners Direct Health $125 117%
Cigna $311 291%
Qualcare $311 - $441 291%
Blue Cross Blue Shield $359 - $374 336%
Horizon Casualty Motor Vehicle $447 419%
Horizon Casualty Workers Comp $447 419%
UnitedHealthcare $496 - $567 464%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Two Stone Harbor Blvd, Cape May Court House, NJ 08210
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals