CMS Price Transparency Data

X-ray, pelvis

Facility: Ocean Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $124
Cash Discount Price: $111
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Ocean Medical Center is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.16x the Medicare baseline. Located in 425 Jack Martin Blvd, Brick, NJ.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$124

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: $111 (104%)

Insurance Median: $124 (116%)

Cash: $111 (104% of Medicare)

Ins. Median: $124 (116% 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
Karna	$15 - $54	14%
UnitedHealthcare	$39 - $295	37%
Amerihealth	$54 - $55	51%
Aetna	$65 - $419	61%
Cigna	$69 - $71	65%
Clover	$87	81%
Seoul Medical Group	$93 - $107	87%
Horizon	$95 - $397	89%
Amerigroup	$106	99%
Vaccn	$106 - $116	99%
Wellcare	$106 - $116	99%
United Community/Americhoice	$112 - $122	105%
Blue Cross Blue Shield	$116	109%
Qualcare	$239 - $423	224%
Oxford	$260 - $295	243%
Activecare First McO	$349 - $409	327%
Intergroup	$349	327%
Bergen Risk	$361	338%
Brighton Health Plan	$385	360%
Prime Health	$399	374%
Multiplan - PHCS	$409 - $424	383%

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 $111.
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 Ocean Medical Center 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.