CMS Price Transparency Data

X-ray, pelvis

Facility: Children's Specialized Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $174
Cash Discount Price: $113
vs. Medicare Baseline: 1.63x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Children's Specialized Hospital is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.63x the Medicare baseline. Located in 200 Somerset St, New Brunswick, NJ.

Cash / Self-Pay

$113

Average discount available for prompt cash payment at this facility.

Insurance Median

$174

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: $113 (106%)

Insurance Median: $174 (163%)

Cash: $113 (106% of Medicare)

Ins. Median: $174 (163% 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
Blue Cross Blue Shield	$16 - $221	15%
Cigna	$136	127%
First Health	$136	127%
Emblem Health	$154	144%
Amerihealth	$171	160%
Aetna	$173 - $174	162%
Fidelis Care	$173	162%
Wellpoint	$173	162%
Qualcare Inc	$176	165%
UnitedHealthcare	$178 - $770	167%

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 $113.
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 Children's Specialized 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.