CMS Price Transparency Data

X-ray, pelvis

Facility: Jamaica Hospital Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $131
Cash Discount Price: $254
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Jamaica Hospital Medical Center is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $254. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.23x the Medicare baseline. Located in 89Th Avenue and Van Wyck Expressway, Jamaica, NY.

Cash / Self-Pay

$254

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $254 (238%)

Insurance Median: $131 (123%)

Cash: $254 (238% of Medicare)

Ins. Median: $131 (123% 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
UnitedHealthcare	$8 - $198	7%
Ghi	$18 - $130	17%
1999 National Benefit Fund	$27	25%
World Trade Center Program	$36 - $51	34%
Healthfirst	$117 - $130	110%
Fidelis	$123 - $130	115%
Aetna	$130 - $158	122%
Beacon Health Strategies	$130	122%
Centerlight Healthcare	$130	122%
Empire	$130 - $295	122%
Hip	$130 - $396	122%
Metroplus	$130 - $143	122%
Elderplan	$132	124%
Vns	$132	124%
Wellcare Of Ny	$135	126%
Humana	$138	129%
Senior Whole Health	$138	129%
Centers Plan For Healthy Living	$143	134%
Hamaspik Choice	$149	140%
Magnacare	$149	140%
Oscar	$182	170%
Emblemhealth	$214	200%
Empire Blue Priority	$251	235%
Hotel Trades Council	$1,912	1790%

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 $254.
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 Jamaica Hospital 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.